Does Facial Gunshot Wound Location Affect the Need for Airway Intervention?

The purpose of this study was to determine the effect of the facial region associated with gunshot wound (GSW) on the need for airway intervention.

This was a cross-sectional study. We reviewed charts of patients treated at Cook County Health from (2008-2018) for GSW injuries involving the face. Data collection included demographics and airway intervention. The region of the face involved in GSW was the predictor variable. Airway intervention via intubation, cricothyrotomy, or tracheostomy was the outcome variable. Chi-square tests and odds ratios were employed for statistical analyses.

Of the 180 GSW patients, 169 were males (94%), and eleven were females (6%). 145 were African American (80.6%), 21 were Hispanic (11.7%), 5 were Caucasian (2.8%), and 9 were of other ethnicities (5%). The median age in this cohort was 25 years (range 16-73 years). The mean was 27.9 years, and 75% of patients were younger than the age of 33 years. The overall rate of airway intervention was 45%. Among patients with injuries to the lower face, 53% required airway management, compared to 33% of patients with injuries to the middle face and 30% of patients with injuries to the upper face. This difference was not statistically significant. Dichotomized data into the upper half and lower half injuries of the face reflected a statistically significant difference in the need for airway intervention (chi-square 4.358, p = 0.037). The odds ratio was 0.3824 and a 95% confidence interval was 0.1532-0.9545.

While only half of GSW patients may require airway intervention, vigilance and close attention should be paid to all patients and especially those with lower half of the face injuries.