Epidemiology of Upper Extremity Firearm Injuries among Major Trauma Hospitals in the United States

Rachel Campbell Hooper · Melissa J. Shauver · Ching-Han Chou · Jung-Shen Chen · Kevin C. Chung

11 citations0/0 files storedPlastic & Reconstructive Surgery

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Gun Ownership and Violence Research Orthopedic Surgery and Rehabilitation Trauma and Emergency Care Studies

Abstract

BACKGROUND: As many as 34 percent of nonfatal firearm injuries involve the upper extremity. Although not lethal, these injuries cause substantial morbidity. The authors conducted an epidemiologic study characterizing upper extremity firearm-related injuries presenting to U.S. trauma centers over a 10-year period. METHODS: The authors used the National Trauma Databank from 2007 to 2017 to identify isolated upper extremity firearm-related injuries. Descriptive statistics were performed to characterize patient demographic data, firearm type, extremity injury patterns, treatments received, hospital length of stay, and regional variation. RESULTS: The authors identified 48,254 upper extremity firearm-related injuries. The patients were largely male patients (85 percent), and over half were between the ages of 20 and 39 years. Handguns (34 percent) were the most frequently used firearm. Shoulder and upper arm were the most frequently injured areas (54 percent); however, 18 percent of patients injured two or more areas. Patients were most often treated at university hospitals (59 percent) with Level I or II trauma designation. Seventy percent were admitted and/or taken directly to the operating room. The mean hospital length of stay was 3 days. Payer mix among these patients was variable: Medicaid, 20 percent; private insurance, 20 percent; and self-pay, 29 percent. CONCLUSIONS: Upper-extremity firearm injuries are resource intensive, with three-quarters of patients requiring operative intervention and/or hospitalization. Level I and II trauma centers were the site of care for the majority of patients. Targeted gun policy reform and prevention measures directed toward at-risk groups have the potential to limit the unnecessary morbidity and costs associated with these injuries.

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2015Firearm injuries in the United States 2016Firearm legislation and firearm mortality in the USA: a cross-sectional, state-level study 2006Parental Misperceptions About Children and Firearms 2017Costs and Financial Burden of Initial Hospitalizations for Firearm Injuries in the United States, 2006–2014 2017The burden of firearm violence in the United States: stricter laws result in safer states 2016An epidemiologic overview of 13 years of firearm hospitalizations in Pennsylvania 2018Epidemiology of gunshot wounds to the hand 2015Orthopaedic firearm injuries in children and adolescents: An eight-year experience at a major urban trauma center

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