Characterizing Firearm-Related Traumatic Brain Injuries at a Trauma Center Near the United States-Mexico Border

Area of Science:

• Neuroscience
• Public Health
• Trauma Surgery

Background:

• Firearm-related traumatic brain injuries (FR-TBIs) represent a significant public health issue affecting both the United States and Mexico.
• A Level 1 trauma center near the U.S.-Mexico border serves a diverse patient population, making it a key location for studying cross-border health impacts.

Purpose of the Study:

• To characterize the demographic, clinical, and outcome data of patients diagnosed with FR-TBI at a Level 1 trauma center near the U.S.-Mexico border.
• To identify and analyze potential disparities in treatment and outcomes between patients from the United States and Mexico.

Main Methods:

• A retrospective cohort review was conducted on patients diagnosed with acute FR-TBI between 2010 and 2023.
• Data collected included demographics, injury characteristics, Glasgow Coma Scale scores, surgical interventions, intracranial pressure monitoring, and hospital outcomes.
• Statistical analyses were performed to compare patient groups from the U.S. and Mexico.

Main Results:

• Eighty-four patients were identified, with 67 from the U.S. and 17 from Mexico. The majority were male (85.7%) and Hispanic (44.0%), with a median age of 34.
• Common injuries included intraparenchymal hemorrhage/contusion, subarachnoid hemorrhage, and subdural hematoma. Fourteen patients required ICP monitoring, and 18 underwent surgery.
• Patients from Mexico exhibited a lower mortality rate (p=0.015), longer hospital stays (p=0.001), and higher total hospital charges (p<0.001) compared to U.S. patients.

Conclusions:

• Significant disparities exist in hospital length of stay and hospital charges for patients from Mexico treated for FR-TBI compared to U.S. patients.
• These findings highlight the increasing burden of FR-TBI on U.S. healthcare systems and suggest the need for further research into pre-hospital factors and the reasons behind these disparities.