Abstract
Background
Shotguns represent a distinct form of ballistic injury because of projectile scatter
and variable penetration. Due in part to their rarity, existing literature on shotgun
injuries is scarce.
Objective
This study defined the epidemiology, injury patterns, and outcomes after shotgun wounds
at a national level.
Methods
Patients with shotgun injury were identified from the National Trauma Data Bank (2007–2014).
Transferred patients and those with missing procedure data were excluded. Demographics,
injury data, and outcomes were collected and analyzed. Categorical variables are presented
as number (percentage) and continuous variables as median (interquartile range).
Results
Shotgun wounds comprised 9% of all firearm injuries. After exclusions, 11,292 patients
with shotgun injury were included. The median age was 29 years (21–43) and most were
male (n = 9887, 88%). Most injuries occurred in the South (n = 4092, 36%) and among
white patients (n = 4945, 44%). The median Injury Severity Score was 9 (3–16). Overall
in-hospital mortality was 14% (n = 1341), with 669 patients (7%) dying in the emergency
department. Assault was the most common injury intent (n = 6762, 60%), followed by
accidental (n = 2081, 19%) and self-inflicted (n = 1954, 17%). The lower and upper
extremities were the most commonly affected body regions (n = 4071, 36% and n = 3422,
30%, respectively), while the head was the most severely injured (median Abbreviated
Injury Scale score 4 [2–5]).
Conclusions
In the United States, shotgun wounds are an infrequent mechanism of injury. Shotgun
wounds as a result of interpersonal violence far outweigh self-inflicted and accidental
injuries. White men in their 20s in the southern parts of the country are most commonly
affected and thereby delineate the high-risk patient population for injury by this
mechanism at a national level.
Keywords
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Article info
Publication history
Published online: March 31, 2020
Accepted:
February 16,
2020
Received in revised form:
February 10,
2020
Received:
November 22,
2019
Footnotes
Reprints are not available.
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.
