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02-08-2023 | Gunshot Wound | Original Scientific Report

Injury Patterns and Treatment Strategies in Civilian and Military Isolated Abdominal Gunshot Wounds

Authors: Joshua Dilday, Natthida Owattanapanich, Elizabeth R. Benjamin, Subarna Biswas, Stacy Shackelford, Demetrios Demetriades

Published in: World Journal of Surgery | Issue 11/2023

Abstract

Background

Combat-related gunshot wounds (GSW) may differ from those found in civilian trauma centers. Missile velocity, resources, logistics, and body armor may affect injury patterns and management strategies. This study compares injury patterns, management, and outcomes in isolated abdominal GSW between military (MIL) and civilian (CIV) populations.

Methods

The Department of Defense Trauma Registry (DoDTR) and TQIP databases were queried for patients with isolated abdominal GSW from 2013 to 2016. MIL patients were propensity score matched 1:3 based on age, sex, and extraabdominal AIS. Injury patterns and in-hospital outcomes were compared. Initial operative management strategies, including selective nonoperative management (SNOM) for isolated solid organ injuries, were also compared.

Results

Of the 6435 patients with isolated abdominal GSW, 183 (3%) MIL were identified and matched with 549 CIV patients. The MIL group had more hollow viscus injuries (84% vs. 66%) while the CIV group had more vascular injuries (10% vs. 21%) (p < .05 for both). Operative strategy differed, with more MIL patients undergoing exploratory laparotomy (95% vs. 82%) and colectomy (72% vs. 52%) (p < .05 for both). However, no difference in ostomy creation was appreciated. More SNOM for isolated solid organ injuries was performed in the CIV group (34.1% vs. 12.5%; p < 0.05). In-hospital outcomes, including mortality, were similar between groups.

Conclusions

MIL abdominal GSW lead to higher rates of hollow viscus injuries compared to CIV GSW. MIL GSW are more frequently treated with resection but with similar ostomy creation compared to civilian GSW. SNOM of solid organ injuries is infrequently performed following MIL GSW.

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Title: Injury Patterns and Treatment Strategies in Civilian and Military Isolated Abdominal Gunshot Wounds
Authors: Joshua Dilday
Natthida Owattanapanich
Elizabeth R. Benjamin
Subarna Biswas
Stacy Shackelford
Demetrios Demetriades
Publication date: 02-08-2023
Publisher: Springer International Publishing
Keywords: Gunshot Wound
Laparotomy
Laparotomy
Published in: World Journal of Surgery / Issue 11/2023
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-023-07132-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Injury Patterns and Treatment Strategies in Civilian and Military Isolated Abdominal Gunshot Wounds

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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