{"pk":14411,"title":"Self-Inflicted Gun Shot Wounds: A Retrospective, Observational Study of U.S. Trauma Centers","subtitle":null,"abstract":"Objectives: \nIntentional self-harm (suicide) by firearms is a growing problem in the United States. Currently, there are no large studies that have identified risk factors for patients who die from self-inflicted gunshot wounds. Our objectives are to 1) identify risk factors for patients with the highest morbidity and mortality from self-inflicted gunshot wounds (SIGSWs) at trauma centers 2) present the outcomes of victims of SIGSW by handguns (HG) versus all other specified guns (AOG) and 3) compare the presentations and outcomes of victims with head or face (HF) injuries to other regions of the body.\n \n \n \n \nMethods: \nWe performed a retrospective analysis from the National Trauma Database (NTDB) data between 2012 and 2013 of all SIGSW patients who presented to trauma centers. Categorical data included patient characteristics upon presentation and outcomes which were compared between patients with HG injury versus AOG injury using the Chi-Squared test, where AOG includes shotguns, hunting rifles, and military firearms. Additionally, analysis of head and face (HF) injuries versus other bodily injuries (OBI) were compared between the HG group versus AOG group using Chi-squared test.\n \n \n \nResults: \nThere were 7828 SIGSWs, of those, 78% (6115) were white and 84.3% (6600) were male. There were 5139 HG injuries, 1130 AOG injuries, and 1405 unidentified gun injuries. The HG group was likely to be older (>55 years old), hypotensive (systolic blood pressure < 90), have a lower Glasgow Coma Score (GCS < 9), use illegal, or use prescription drugs. In comparing HF injuries (4799) versus other bodily injuries (OBI) (3028), HF group was more likely to use handguns, expire in ED, require ICU, and have a higher percent of overall mortality. Of the total OBI, the thorax, upper extremities, and abdomen were the most commonly injured.\n \n \n \nConclusion: \nIn our retrospective study of SIGSWs, we were able to demonstrate that SIGSW by handguns are more lethal, and confer a higher proportion of severe injuries versus all other types of firearms. SIGSWs in older white males with handguns are the most at-risk for severe complications. Future efforts should improve screening methods for handguns in suicidal patients and at developing prevention programs.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"self-inflicted gunshot, suicide, intentional firearm injury, handgun injury, gun violence restraining orders"}],"section":"Violence Assessment and Prevention","is_remote":true,"remote_url":"https://escholarship.org/uc/item/6c32292h","frozenauthors":[{"first_name":"Faith","middle_name":"","last_name":"Quenzer","name_suffix":"","institution":"University of California, San Diego, Department of Emergency Medicine, San Diego, California","department":"None"},{"first_name":"Andrew","middle_name":"","last_name":"Givner","name_suffix":"","institution":"Desert Regional Medical Center, Department of Emergency Medicine, Palm Springs, California","department":"None"},{"first_name":"Rachel","middle_name":"","last_name":"Dirks","name_suffix":"","institution":"University of California, San Francisco-Fresno, Department of Emergency Medicine, Fresno, California","department":"None"},{"first_name":"Christopher","middle_name":"J.","last_name":"Coyne","name_suffix":"","institution":"University of California, San Diego, Department of Emergency Medicine, San Diego, California","department":"None"},{"first_name":"Frank","middle_name":"","last_name":"Ercoli","name_suffix":"","institution":"Desert Regional Medical Center, Department of Emergency Medicine, Palm Springs, California\nDesert Regional Medical Center, Desert Trauma Surgeons, Palm Springs, California","department":"None"},{"first_name":"Ricard","middle_name":"","last_name":"Townsend","name_suffix":"","institution":"Desert Regional Medical Center, Department of Emergency Medicine, Palm Springs, California\nDesert Regional Medical Center, Desert Trauma Surgeons, Palm Springs, California","department":"None"}],"date_submitted":"2020-07-30T01:21:42Z","date_accepted":"2020-07-30T01:21:42Z","date_published":"2021-05-19T19:12:57Z","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/14411/galley/7396/download/"}]}