Emergency Anesthesiology Encounters, Care Practices, and Outcomes for Patients with Firearm Injuries: A 9-Year Single-Center US Level 1 Trauma Experience
Authors' conclusion
Over the study period, anesthesiologists increasingly cared for patients with firearm injuries, who often present outside of daytime hours and require urgent operative intervention.
Study context
- Population
- Adults ≥18 years admitted to a regional US Level 1 trauma center, 2014–2022, requiring operative management within 2 hours of arrival4.7% of injured patients
- Participants
- 2,124 adults
- Exposure
- Firearm vs nonfirearm injuries
- Firearmn = 541
- Nonfirearmn = 1,583reference
- Outcome
- Anesthesia care, resource utilization and outcomes
Methodological detailssingle-centre, Level 1 trauma centre
- Single-centre
- Level 1 trauma centre
Main finding
As reported in the abstract
- Age, years (median [IQR]): firearm 30 [23-40] vs nonfirearm 41 [29-56]
- P < .0001
- Male: 90% vs 75%
- P < .0001
- Polytrauma: 10% vs 22%
- P < .0001
- Arrived after hours: 73% vs 63%
- P < .0001
- Time to anesthesiology care, hours after arrival: 0.4 [0.3-0.7] vs 0.9 [0.5-1.5]
- P < .0001
- Invasive arterial cannulation: 83% vs 77%
- P < .0001
- Central venous cannulation: 14% vs 10%
- P = .02
- Blood products, units: 3 [0-11] vs 0 [0-7]
- P < .0001
- TXA: 30% vs 22%
- P < .001
- Estimated blood loss, mL: 500 [200-1588] vs 300 [100-1000]
- P < .0001
- Intensive care unit (ICU) transfer: 83% vs 77%
- P < .001
Observational data: associations, not effects.
Further findings
Intraoperative mortality
Postoperative mortality (intraoperative survivors)
P < 0.0001
| Outcome | P value |
|---|---|
| Discharge to home or jailMore often in firearm | P < 0.001 |
Intraoperative mortality
- Comparable
Yearly average increase in trauma admissions
- Firearm
- 10.1%
- Blunt
- 3.2%
- Other
- 1.3%
- Motor-vehicle crash
- 0.9%
Original publication
Emergency Anesthesiology Encounters, Care Practices, and Outcomes for Patients with Firearm Injuries: A 9-Year Single-Center US Level 1 Trauma Experience. Anesth Analg. Published 23 August 2024. doi:10.
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