Nonfatal Firearm-Related Vascular Injuries: Clinical and Financial Implications in Trauma Care

Area of Science:

• Trauma Surgery
• Vascular Surgery
• Public Health

Background:

• Gun violence is a major public health crisis, causing severe vascular injuries with high morbidity and mortality.
• Firearm-related vascular trauma leads to significant long-term disability, economic burden, and increased healthcare resource utilization.
• Complex surgical interventions and extensive postoperative care are often required for major vascular injuries, increasing costs and hospital stays.

Purpose of the Study:

• To examine the cost, length of stay, and surgical burden associated with nonfatal firearm injuries (NFIs) involving vascular trauma.
• To explore the potential role of endovascular techniques in reducing complications and costs compared to traditional open surgery.
• To understand the financial and clinical impact of vascular firearm injuries for optimizing treatment strategies.

Main Methods:

• Retrospective review of a level-one academic trauma center registry from 2019-2021.
• Inclusion criteria: all patients with nonfatal firearm injuries (NFIs).
• Descriptive analysis and independent samples T-tests were performed using IBM SPSS (version 29.0).

Main Results:

• Of 359 patients, 104 (29%) sustained vascular injuries.
• Vascular injury patients had significantly higher mean total costs ($49,050 vs. $31,763, P=0.006) and longer mean length of stay (10.88 vs. 7.68 days, P=0.012).
• Vascular trauma patients required more operating room trips (2.53 vs. 1.61, P=0.013).

Conclusions:

• Optimizing trauma management for vascular injuries is crucial due to high resource utilization.
• Endovascular techniques show promise as a less invasive, potentially cost-effective alternative to open repair.
• Further research into cost-effective strategies, including endovascular interventions, is needed to improve outcomes for vascular firearm injuries.