Psychosocial Risk Factors Associated With Facial Self-Inflicted and Assault-Related Gunshot Wounds at A Southeastern...

Area of Science:

• Trauma Surgery
• Public Health
• Psychiatry

Background:

• Firearm injuries are a significant cause of mortality in the U.S.
• Limited research exists on psychiatric and social factors for facial self-inflicted gunshot wounds (SIGSWs) and assault-related gunshot wounds (AGSWs).
• High firearm violence regions necessitate understanding these risk factors.

Purpose of the Study:

• Identify factors associated with injury intent (SIGSW vs. AGSW) for facial gunshot wounds.
• Determine predictors of mortality in facial firearm injury cases.
• Analyze psychosocial profiles and healthcare engagement in facial firearm injury patients.

Main Methods:

• Retrospective medical record review of 409 facial gunshot wound cases (2017-2024) at a Level 1 trauma center.
• Multivariable logistic regression models to assess predictors of injury intent and mortality.
• False discovery rate (FDR) correction applied for multiple comparisons.

Main Results:

• Mortality was significantly higher for SIGSWs (48.7%) compared to AGSWs (21.0%).
• SIGSWs were associated with increased odds of mortality (aOR=5.19).
• Prior psychiatric diagnosis and uninsured status were linked to lower odds of self-inflicted injury. A significant interaction between injury intent and sex was observed, with a larger mortality difference among females.

Conclusions:

• Facial SIGSWs and AGSWs exhibit distinct clinical and psychosocial profiles.
• Psychiatric history and insurance status are key indicators of risk and healthcare engagement.
• Findings can inform targeted screening, prevention, and post-injury care for facial firearm injury.