scholarly journals Outcome of cranial firearm injuries in civilian population based on a novel classification system

2020 ◽  
Vol 11 ◽  
pp. 167
Author(s):  
Farrukh Javeed ◽  
Asad Abbas ◽  
Lal Rehman ◽  
Syed Raza Khairat Rizvi ◽  
Ali Afzal ◽  
...  
Keyword(s):  
Surgical Intervention ◽  
Population Based ◽  
Financial Loss ◽  
Civilian Population ◽  
Pattern Of Injury ◽  
Wound Debridement ◽  
Firearm Injuries ◽  
Gunshot Injuries ◽  
Moderate Traumatic Brain Injury ◽  
Gender Pattern

Background: Cranial firearm injuries (CFAIs) are expected to be frequent during warfare; however, it is becoming increasingly common among civilian population in our part of the world. These injuries are associated with significant morbidity and mortality in addition to financial loss. The objective of our study is to evaluate the pattern of gunshot injuries to cranium and their outcome. Methods: The study was conducted on 114 patients presenting with CFAIs to Jinnah Postgraduate Medical Centre, Karachi, Pakistan, between June 2015 and January 2019. Patients were evaluated with respect to age, gender, pattern of injury, Glasgow coma scale on arrival, radiological and clinical assessment, surgical intervention, and Glasgow outcome score measured at 6 months follow-up. Results: Among patients with cranial gunshot, injuries most were males (76.3%). More than 50% patients aged between 18 and 35 years. About 46.5% of patients presented with moderate traumatic brain injury commonly involving the temporal lobe (36.8%). Of total 114 patients, 84.2% were managed conservatively but wound debridement was done in all patients. At 6 months, the overall mortality in our patients was 33.3%. Patients with good outcome (GOS 4 and 5) were 30.7% and 35.9% patients had bad outcome (GOS 2 and 3). Complication rate was 14.9% and the most common complication was disseminated intravascular coagulation in 5.2%. Conclusion: Surgical intervention has no significant benefit over conservative management on long-term mortality and should be limited to patients with large intracranial hematomas and intraventricular hematomas causing hydrocephalus.

scholarly journals Concerns in the Norwegian Population during the Initial Lockdown Due to the COVID-19 Pandemic

2021 ◽  
Vol 18 (11) ◽  
pp. 6119
Author(s):  
Inger Schou-Bredal ◽  
Laila Skogstad ◽  
Tine K. Grimholt ◽  
Tore Bonsaksen ◽  
Øivind Ekeberg ◽  
...  
Keyword(s):  
Online Survey ◽  
Female Gender ◽  
Population Based ◽  
Snowball Sampling ◽  
Financial Loss ◽  
Next Of Kin ◽  
Cross Sectional ◽  
Norwegian Population ◽  
Gender And Age ◽  
Response Alternatives

Although concern affects one’s welfare or happiness, few studies to date have focused on peoples’ concerns during the initial COVID-19 lockdown. The aim of the study was to explore concerns in the Norwegian populations according to gender and age, and identify which concerns were most prominent during the lockdown. A population-based cross-sectional online survey using snowball-sampling strategies was conducted, to which 4527 adults (≥18 years) responded. Questions related to concerns had response alternatives yes or no. In addition, they were asked which concern was most prominent. Nearly all the 4527 respondents (92%) reported that they were concerned: 60.9% were generally concerned about the pandemic, 83.9% were concerned about family and friends, 21.8% had financial concerns, and 25.3% expected financial loss. More women were concerned about family and friends than males, (85.2% vs. 76.2%, p < 0.001), whereas more men expected financial loss (30.4% vs. 24.4%y, p = 0.001). Younger adults (<50 years) had more financial concerns than older adults (25.9% vs. 10.5%, p < 0.001). Being concerned about family and friends was the most prominent concern and was associated with; lower age (OR 0.79), female gender (OR 1.59), and being next of kin (2.42). The most prominent concern for adults 70 years or older was being infected by COVID-19. In conclusion, women and younger individuals were most concerned. While adults under 70 years of age were most concerned about family and friends and adults 70 years or older were most concerned about being infected by COVID-19.

scholarly journals Prevalence of injury and its associated factors in a rural area of eastern Nepal

2017 ◽  
Vol 6 (4) ◽  
pp. 7-13 ◽  
Author(s):  
V K Khanal ◽  
R Upreti ◽  
U Oli ◽  
A K Sunny ◽  
A Ghimire ◽  
...  
Keyword(s):  
Rural Area ◽  
Associated Factors ◽  
Population Based ◽  
Cross Sectional Study ◽  
Common Type ◽  
Injury Pattern ◽  
Sectional Study ◽  
Cross Sectional ◽  
Pattern Of Injury ◽  
Public Health Threat

Injury is a serious public health threat as it is one of the leading cause of death globally. This study aims to assess the prevalence of injury, pattern of injury and its associated factors among people residing in a rural area of Aurabani VDC of Eastern Nepal. A population based cross sectional study was carried out among 552 people residing in selected wards with door to door visit. The prevalence of minor injury was 3.1% and major was 0.4% per year in the study.Most common mode of injury was fall and most common type was incised wound. Injuries mostly occurred in extremities, in morning time, autumn season and in roads while most of the injuries were accidental in nature. 

Pediatric Firearm Injuries, Kansas City, 1992: A Population-Based Study

PEDIATRICS ◽  
1994 ◽  
Vol 94 (6) ◽  
pp. 867-873 ◽  
Author(s):  
M. Denise Dowd ◽  
Jane F. Knapp ◽  
Laura S. Fitzmaurice
Keyword(s):  
Kansas City ◽  
Population Based ◽  
Case Definition ◽  
Medical Examiner ◽  
Care Providers ◽  
Unintentional Injuries ◽  
Permanent Disability ◽  
Census Tracts ◽  
Firearm Injury ◽  
Firearm Injuries

Objective. To determine the morbidity, mortality, and epidemiologic features of pediatric powder-firearm injuries in a defined urban population. Design and setting. A population-based, descriptive epidemiologic study was conducted of firearm injuries to children in a mid-size urban community (total population: 435 178) in 1992. The population was 56% white and 39% black. Data from prehospital care providers, all city and adjacent community hospitals, and medical examiner and police records were searched for cases of firearm injury. The 1990 United States census provided denominator data. Case definition. Subjects were all 0- to 16-year-old residents of Kansas City, Missouri who sought medical treatment at a hospital for a powder-firearm injury or who presented to the medical examiner with a fatal firearm injury in calendar year 1992. Results. Seventy-two children met the case definition, for an incidence of 70 per 100 000 persons per year. There were 12 (16.7%) fatalities, for a mortality rate of 11.7 per 100 000 persons per year. Almost 10% of the patients sustained permanent disability. Mean and median ages of the patients were 14.9 years and 15.8 years, respectively; 79% were male and 82% were black. The majority of the children (63%) lived in census tracts with a high proportion of families in poverty. Black males had the highest rates of firearm injury, with a 1-year incidence of 233 per 100 000 persons per year. At younger than 12 years, the rates were equal among the races; however, for those 12 years and older, black adolescents had 13 times the risk of white adolescents (541 compared to 42 per 100 000 persons per year). The majority (71%) of injuries were due to assaults, with drive-by shootings the most frequent circumstance. The majority of unintentional injuries occurred to adolescents as the result of an unplanned discharge of a handgun as it was being placed in or removed from concealment. Among the patients, 39% were admitted to the hospital and 26% required surgery. Conclusions. 1) Black male adolescents had the highest risk of firearm injury or fatality. 2) The majority of victims lived in census tracts characterized by poverty. 3) Injuries were alarmingly severe. 4) Interpersonal violence was the leading contributor to fatal and nonfatal injuries. 5) Unintentional injuries characteristically occurred during the process of weapon concealment. 6) The leading contributor to injury and death was the interaction of adolescents and guns, particularly handguns. The main implication for firearm-injury prevention in this population is the limiting of access to guns by adolescents. In addition, measures aimed at preventing violent behavior, such as education in nonviolent methods of conflict resolution, should be explored.

scholarly journals Pattern of firearm injuries managed at rural tertiary centre in Western Uttar Pradesh, North India

2017 ◽  
Vol 4 (8) ◽  
pp. 2677
Author(s):  
Shailendra Pal Singh ◽  
Pradeep Kumar Singh ◽  
Manas Prakash ◽  
Praveen Singh ◽  
Gyanendra Chaudhary
Keyword(s):  
Financial Burden ◽  
Winter Season ◽  
Public Health Problem ◽  
Legal Aspects ◽  
North India ◽  
Physical Factors ◽  
Global Public Health ◽  
Firearm Injury ◽  
Wound Debridement ◽  
Firearm Injuries

Background: Firearm injuries are associated with substantial emotional, physical and financial burden on community and hospital resources leads to profound morbidity. It is a global public health problem and pose therapeutic challenges to surgeons. Proper management of firearm wounds requires a working knowledge of physical factors involved in the creation of such injuries. Regional variations of the parameters of medico legal aspects of firearm injuries are still lacking. Objective is to analyse pattern of firearm injuries managed at rural tertiary hospital.Methods: All firearm injury cases brought to the emergency department of Hospital, from January 2016 to December 2016 were included in the study.Results: In this study 108 (83.7%) victims were males and 21 (16.3%) were female. Most common age group victimized was 20-29 year (33.3%). Most cases occurred in winter season.113 cases (87.3%) victim were unemployed.81 cases (62.8%) had below intermediate education. 110 (85.3%) cases were of homicidal motive. Shotgun/ ‘kattas’ outnumbered the rifled firearm injuries (109) cases (84.5%). Trunk was involved in 45 cases (34.8%) and lower extremity in (32.6%) 42 cases,) Exit wound found in 93(72.2%) cases only. The fatality rate was 3.9% (5 cases). . Wound debridement was performed for 48 cases (37.2%) of patients, while emergency exploration was done for 30 cases (23.3%). The hospital stay of 49 cases (37.9%) of patients was more than one week. 111 cases (86.1%) were discharged.Conclusions: Addressing the root causes of violence such as poverty, unemployment, substance abuse will reduce the incidence of firearm injuries in our environment. Establishment of efficient emergency health care services for pre-hospital care and effective ambulance system for rapid transport of injured victims to hospital will reduce morbidity and mortality. Management requires knowledge ATLS protocols, mode, presentation and ballistic of firearm. Authorities issuing license for possession of firearms need to be more strict and vigilant.

High-Velocity Gunshot Wounds to the Head and Neck: A Review of Wound Ballistics

1998 ◽  
Vol 163 (5) ◽  
pp. 346-351 ◽  
Author(s):  
Sertac Yetiser ◽  
Mustafa Kahramanyol
Keyword(s):  
Head And Neck ◽  
Tissue Damage ◽  
High Velocity ◽  
Gunshot Wounds ◽  
Wound Ballistics ◽  
Firearm Injuries ◽  
Gunshot Injuries ◽  
Exit Wound ◽  
Life Threatening ◽  
Distinct Features

Abstract Patients who sustain gunshot injuries to the head and neck face heavy tissue damage and eventually life-threatening conditions. A very significant factor that determines the degree of injury is the course and extent of the missile track. The missile track is well correlated with bullet structure, size, and velocity, which have distinct features in civilian and military firearm injuries. The missile entrance or exit wound may be out of sight in some injuries, and often it is difficult to predict the severity of the injury in the chaotic circumstances of the battlefield. We studied the wound ballistics in five soldiers who suffered penetrating cranial and cervical firearm injuries.

Gunshot Injuries in Children Served by Emergency Services

2017 ◽  
pp. 127-137
Author(s):  
Craig D. Newgard ◽  
Nathan Kuppermann ◽  
James F. Holmes ◽  
Jason S. Haukoos ◽  
Brian Wetzel ◽  
...  
Keyword(s):  
Emergency Medical Services ◽  
Injury Severity ◽  
Emergency Services ◽  
Population Based ◽  
Adverse Outcomes ◽  
Medical Services ◽  
Major Surgery ◽  
Gunshot Injuries ◽  
Emergency Medical ◽  
Injury Mechanisms

OBJECTIVE To describe the incidence, injury severity, resource use, mortality, and costs for children with gunshot injuries, compared with other injury mechanisms. METHODS This was a population-based, retrospective cohort study (January 1, 2006–December 31, 2008) including all injured children age ≤19 years with a 9-1-1 response from 47 emergency medical services agencies transporting to 93 hospitals in 5 regions of the western United States. Outcomes included population-adjusted incidence, injury severity score ≥16, major surgery, blood transfusion, mortality, and average per-patient acute care costs. RESULTS A total of 49 983 injured children had a 9-1-1 emergency medical services response, including 505 (1.0%) with gunshot injuries (83.2% age 15–19 years, 84.5% male). The population-adjusted annual incidence of gunshot injuries was 7.5 cases/100 000 children, which varied 16-fold between regions. Compared with children who had other mechanisms of injury, those injured by gunshot had the highest proportion of serious injuries (23%, 95% confidence interval [CI] 17.6–28.4), major surgery (32%, 95% CI 26.1–38.5), in-hospital mortality (8.0%, 95% CI 4.7–11.4), and costs ($28 510 per patient, 95% CI 22 193–34 827). CONCLUSIONS Despite being less common than other injury mechanisms, gunshot injuries cause a disproportionate burden of adverse outcomes in children, particularly among older adolescent males. Public health, injury prevention, and health policy solutions are needed to reduce gunshot injuries in children.

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