Top

European Journal of Trauma and Emergency Surgery

Published in:

07-07-2021 | Gunshot Wound | Original Article

Gunshot and stab wounds in France: descriptive study from a national trauma registry

Authors: Chloé Descamps, Sophie Hamada, Jean-Luc Hanouz, Fanny Vardon-Bounes, Arthur James, Delphine Garrigue, Paer Abback, Mickaël Cardinale, Guillaume Dubreuil, Jeanne Chatelon, Fabrice Cook, Arthur Neuschwander, Nathalie de Garambé, Sylvain Ausset, Mathieu Boutonnet, Traumabase Group

Published in: European Journal of Trauma and Emergency Surgery | Issue 5/2022

Abstract

Purpose

Severe trauma is a major problem worldwide. In France, blunt trauma (BT) is predominant and few studies are available on penetrating trauma (PT). The purpose of this study was to perform a descriptive analysis of severe gunshot (GSW) and stab wounds (SW) in patients who were treated in French trauma centers.

Methods

Retrospective study on prospectively collected data in a national trauma registry. All adult (> 15 years) trauma patients primarily admitted in 1 of the 17 trauma centers members of the Traumabase between January 2015 to December 2018 were included. Data from patients who had a PT were compared with those who had suffered a BT over the same period. Due to the known differences between GSW and SW, sub-group analyses on data from GSW, SW and BT were also performed.

Results

8128 patients were included. Twelve percent of the study group had a PT. The main mechanism of PT was SW (68.1%). Five hundred and eighty patients with PT (59.4%) required surgery within the first 24 h. Severe hemorrhage was more frequent in penetrating traumas (11.2% vs. 7.8% p < 0.001). Hospital mortality following PT was 8.9% vs 11% for blunt trauma (p = 0.047). Among PT the mortality after GSW was ten times higher than after SW (23.8% vs 2%).

Conclusion

This work is the largest study to date that has specifically focused on GSW and SW in France, and will help improving knowledge in managing such patients in our country.

Available only for authorised users

World health organization. Injuries and Violence, the facts. 2014. https://apps.who.int/iris/bitstream/handle/10665/149798/9789241508018_eng.pdf?sequence=1&isAllowed=y. Accessed 28 Jan 2021.

Krug EG, Sharma GK, Lozano R. The global burden of injuries. Am J Public Health. 2000;90(4):523–6.CrossRef

Søreide K. Epidemiology of major trauma. BJS. 2009;96(7):697–8.CrossRef

Fu CY, Bajani F, Tatebe L, Butler C, Starr F, Dennis A, Kaminsky M, et al. Right hospital, right patients: penetrating injury patients treated at high-volume penetrating trauma centers have lower mortality. J Trauma Acute Care Surg. 2019;86(6):961–6.CrossRef

MacKenzie EJ, Rivara FP, Jurkovich GJ, Nathens AB, Frey KP, Egleston BL, et al. A National evaluation of the effect of trauma-center care on mortality. N Engl J Med. 2006;354(4):366–78.CrossRef

Dutton RP, Stansbury LG, Leone S, Kramer E, Hess JR, Scalea TM. Trauma mortality in mature trauma systems: are we doing better? an analysis of trauma mortality patterns, 1997–2008. J Trauma. 2010;69(3):620–6.PubMed

Schreyer N, Carron P, Demartines N, Yersin B. Stab wounds in a swiss emergency department: a series of 80 consecutive cases. Swiss Med Wkly. 2010;24(140):w13058.

Spijkers ATE, Meylaerts SAG, Leenen LPH. Mortality decreases by implementing a level I trauma center in a Dutch hospital. J Trauma. 2010;69(5):1138–42.PubMed

Nagata I, Abe T, Uchida M, Saitoh D, Tamiya N. Ten-year inhospital mortality trends for patients with trauma in Japan: a multicentre observational study. BMJ Open. 2018;8(2): e018635. https://doi.org/10.1136/bmjopen-2017-018635.CrossRefPubMedPubMedCentral

10.

Sakran JV, Mehta A, Fransman R, Nathens AB, Joseph B, Kent A, et al. Nationwide trends in mortality following penetrating trauma: are we up for the challenge? J Trauma Acute Care Surg. 2018;85(1):160–6.CrossRef

11.

The Global Burden of Disease 2016 Collaborators. Naghavi M, Marczak LB, Kutz M, Shackelford KA, Arora M, Miller-Petrie M, et al. Global Mortality From Firearms, 1990–2016. JAMA. 2018;320(8):792–814.

12.

Inkinen J, Kirjasuo K, Gunn J, Kuttila K. Penetrating trauma; experience from Southwest Finland between 1997 and 2011, a retrospective descriptive study. Eur J Trauma Emerg Surg. 2015;41(4):429–33.CrossRef

13.

Christensen MC, Nielsen TG, Ridley S, Lecky FE, Morris S. Outcomes and costs of penetrating trauma injury in England and Wales. Injury. 2008;39(9):1013–25.CrossRef

14.

Johannesdottir U, Jonsdottir GM, Johannesdottir BK, Heimisdottir AA, Eythorsson E, Gudbjartsson T, et al. Penetrating stab injuries in Iceland: a whole-nation study on incidence and outcome in patients hospitalized for penetrating stab injuries. Scand J Trauma Resusc Emerg Med. 2019;27(1):7. https://doi.org/10.1186/s13049-018-0582-2.CrossRefPubMedPubMedCentral

15.

Störmann P, Gartner K, Wyen H, Lustenberger T, Marzi I, Wutzler S. Epidemiology and outcome of penetrating injuries in a Western European urban region. Eur J Trauma Emerg Surg. 2016;42(6):663–9.CrossRef

16.

Hamada SR, Rosa A, Gauss T, Desclefs JP, Raux M, Harrois A, et al. Development and validation of a pre-hospital “Red Flag” alert for activation of intra-hospital haemorrhage control response in blunt trauma. Crit Care. 2018;22(1):113. https://doi.org/10.1186/s13054-018-2026-9

17.

Riou B, Thicoïpe M, Atain-Kouadio P, Carli P. SAMU Actualités en réanimation préhospitalière: Le traumatisé grave. J Sci. 2002;115:28

18.

Whittaker G, Norton J, Densley J, Bew D. Epidemiology of penetrating injuries in the United Kingdom: a systematic review. Int J Surg. 2017;41:65–9. https://doi.org/10.1016/j.ijsu.2017.03.051.CrossRefPubMed

19.

Wafaisade A, Paffrath T, Lefering R, Ludwig C, Fröhlich M, Mutschler M, et al. The committee on emergency medicine, intensive care and trauma management of the German Trauma Society (Section NIS). Patterns of early resuscitation associated with mortality after penetrating injuries. Br J Surg. 2015;102(10):1220–1228. https://doi.org/10.1002/bjs.9869.

20.

The TRAUMABASE Group, Raux M, Carli P, Lapostolle F, Langlois M, Yordanov Y, Féral-Pierssens AL, et al. Analysis of the medical response to november 2015 paris terrorist attacks: resource utilization according to the cause of injury. Intensive Care Med. 2019;45(9):1231–1240. https://doi.org/10.1007/s00134-019-05724-9.

21.

Gauss T, Ageron FX, Devaud M, Debaty G, Travers S, Garrigue D, et al. Association of prehospital time to in-hospital trauma mortality in a physician-staffed emergency medicine system. JAMA Surg. 2019;154(12):1117. https://doi.org/10.1001/jamasurg.2019.3475.CrossRefPubMedPubMedCentral

22.

Martinez T, François A, Hamada SR, Raux M, Ausset S, The TRAUMABASE group. Blood product needs and transfusion timelines for the multisite massive paris 2015 terrorist attack: a retrospective analysis. J Trauma Acute Care Surg. 2020;89(3). https://doi.org/10.1097/TA.0000000000002729.

23.

Taichman DB, Bauchner H, Drazen JM, Laine C, Peiperl L. Firearm-Related Injury and Death — A U.S. Health Care Crisis in Need of Health Care Professionals. N Engl J Med. 2017;377(21):2090–1. https://doi.org/10.1056/NEJMe1713355.CrossRefPubMed

24.

Spitzer SA, Pear VA, McCort CD, Wintemute GJ. Incidence, Distribution, and Lethality of Firearm Injuries in California From 2005 to 2015. JAMA Netw Open. 2020;3(8):e2014736. https://doi.org/10.1001/jamanetworkopen.2020.14736.CrossRefPubMedPubMedCentral

25.

Skarupa DJ, Khan M, Hsu A, Madbak FG, Ebler DJ, Yorkgitis B, et al. Trends in civilian penetrating brain injury: a review of 26,871 patients. Am J Surg. 2019;218(2):255–60. https://doi.org/10.1016/j.amjsurg.2018.11.034.CrossRefPubMed

Title: Gunshot and stab wounds in France: descriptive study from a national trauma registry
Authors: Chloé Descamps
Sophie Hamada
Jean-Luc Hanouz
Fanny Vardon-Bounes
Arthur James
Delphine Garrigue
Paer Abback
Mickaël Cardinale
Guillaume Dubreuil
Jeanne Chatelon
Fabrice Cook
Arthur Neuschwander
Nathalie de Garambé
Sylvain Ausset
Mathieu Boutonnet
Traumabase Group
Publication date: 07-07-2021
Publisher: Springer Berlin Heidelberg
Keyword: Gunshot Wound
Published in: European Journal of Trauma and Emergency Surgery / Issue 5/2022
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-021-01742-9

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Gunshot and stab wounds in France: descriptive study from a national trauma registry

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 5/2022

Hospital preparedness for mass gathering events and mass casualty incidents in Matera, Italy, European Capital of Culture 2019

Changing from a two-tiered to a one-tiered trauma team activation protocol: a before–after observational cohort study investigating the clinical impact of undertriage

The effect of anteromedial support plate with three cannulated screws in the treatment of Pauwels type III femoral neck fracture in young adults

Primary or revision arthroplasty with an integrated acetabular cup—MUTARS® RS cup system

Correction to: Diagnostic options for blunt abdominal trauma

Tibial plateau fracture: does fracture classification influence the choice of surgical approach? A retrospective multicenter analysis