Does Traumatic Brain Injury by Firearm Injury Accelerates the Brain Death Cascade? Preliminary Results

Cacciatori, A.; Godino, M.; Mizraji, R.

doi:10.1016/j.transproceed.2018.01.009

Transplantation Proceedings

2018

DOI: 10.1016/j.transproceed.2018.01.009

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Does Traumatic Brain Injury by Firearm Injury Accelerates the Brain Death Cascade? Preliminary Results

A. Cacciatori¹,

M. Godino²,

R. Mizraji³

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Cited by 4 publications

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“…8 Neurosurgeons are all too familiar with the complex management of these injuries, with primary injury to the brain tissue compounded by downstream effects of secondary injury, as well as possible associated cerebrovascular injuries, cerebrospinal fluid leakage problems, and other craniofacial or polytrauma issues. 9-12 Many patients suffer from debilitating neurological deficits even after neurosurgical intervention. 8,13…”

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confidence: 99%

Letter: A Call to Action: A Neurosurgeon's Responsibility in Firearm Injury Prevention and Advocacy

Chang,

Anderson,

Shao

et al. 2024

Neurosurgery

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the Centers for Disease Control and Prevention highlighted the alarming prevalence of firearm violence in the United States with 48 000 firearm-related deaths annually, equating to an average of 132 people succumbing to firearm-related injuries daily. 1 In 2021, 54% of all firearm-related deaths in the United States were attributed to suicide, 43% were murders, and the remaining were accidental, law enforcement, or undetermined circumstances. 2 More recently, the harrowing mass shooting in Maine that left 18 dead and 13 injured demonstrates the increasingly urgent need for more active physician participation in firearm injury prevention and advocacy, particularly from neurosurgeons. 3 The concerning trend of escalating firearm injuries and violence continues to worsen. The Pew Research Center reports a 23% increase in firearm-related deaths, a 45% increase in firearm-related murders, and a 10% increase in firearm-related suicides since 2019. 2 Firearm injuries and deaths disproportionately affect Black, American Indian, Alaska Native, and Hispanic populations-groups already marginalized within the health care system and neurosurgical/ neurological care. 1,4,5 In deaths among children, adolescents, and young adults, firearm-related injuries surpassed motor vehicle accidents as the most common cause of death from injury in 2017. 6 These facts unequivocally demonstrate the severity of the violent epidemic that plagues our most vulnerable populations and the need for an urgent and collective effort to help prevent firearm injuries.Neurosurgeons play a life-saving role in firearm-related traumatic brain injuries (TBIs). However, we cannot save them all, and these injuries are often deadly, even for those who can make it to the hospital. One study showed that half of individuals who were initially alive at the scene of a firearm-related TBI and were triaged to a level I or II trauma center died because of initial injury. 7 The American Association of Neurological Surgeons (AANS) estimates that 12% of all TBIs in the country are attributable to firearms and that 90% of these are eventually fatal. 8 Neurosurgeons are all too familiar with the complex management of these injuries, with primary injury to the brain tissue compounded by downstream effects of secondary injury, as well as possible associated cerebrovascular injuries, cerebrospinal fluid leakage problems, and other craniofacial or polytrauma issues. 9-12 Many patients suffer from debilitating neurological deficits even after neurosurgical intervention. 8,13 In 2019, physician leaders joined forces to address this urgent public health crisis with a strategic plan for reducing firearm injury, disability, and death, formulated by the

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confidence: 99%

Letter: A Call to Action: A Neurosurgeon's Responsibility in Firearm Injury Prevention and Advocacy

Chang,

Anderson,

Shao

et al. 2024

Neurosurgery

View full text Add to dashboard Cite

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“…12 This is due to the highly destructive nature of a firearm-related primary and secondary injury to brain tissue and the potential for associated pathophysiology involved in this type of trauma (e.g., cardiac arrest). [13][14][15] Firearm-related TBIs commonly lead to hemorrhage, further cerebrovascular injury, cerebrospinal fluid leak, and introduction of foreign material into brain, all of which contribute to a higher risk of morbidity and mortality as compared with those with non-pTBI or blunt TBI mechanisms. 16,17 Advances in medical and prehospital care have improved mortality rates and facilitated the development of clinical guidelines for treating patients after a firearm-related TBI.…”

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confidence: 99%

Firearm-Related Traumatic Brain Injury Homicides in the United States, 2000-2019

et al. 2023

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BACKGROUND: Traumatic brain injury (TBI) is a leading cause of homicide-related death in the United States. Penetrating TBI associated with firearms is a unique injury with an exceptionally high mortality rate that requires specialized neurocritical trauma care. OBJECTIVE: To report incidence patterns of firearm-related and nonfirearm-related TBI homicides in the United States between 2000 and 2019 by demographic characteristics to provide foundational data for prevention and treatment strategies. METHODS: Data were obtained from multiple cause of death records from the National Vital Statistics System using Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research database for the years 2000 to 2019. Number, age-adjusted rates, and percent of firearm and nonfirearm-related TBI homicides by demographic characteristics were calculated. Temporal trends were also evaluated. RESULTS: During the study period, there were 77 602 firearm-related TBI homicides. Firearms were involved in the majority (68%) of all TBI homicides. Overall, men, people living in metro areas, and non-Hispanic Black persons had higher rates of firearm-related TBI homicides. The rate of nonfirearm-related TBI homicides declined by 40%, whereas the rate of firearm-related TBI homicides only declined by 3% during the study period. There was a notable increase in the rate of firearm-related TBI homicides from 2012/2013 through 2019 for women (20%) and nonmetro residents (39%). CONCLUSION: Firearm-related violence is an important public health problem and is associated with the majority of TBI homicide deaths in the United States. The findings from this study may be used to inform prevention and guide further research to improve treatment strategies directed at reducing TBI homicides involving firearms.

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Organ Use Rate: A New Indicator of Donation and Transplantation Efficiency

Carámbula

Mizraji

Godino

et al. 2020

Transplantation Proceedings

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Does Traumatic Brain Injury by Firearm Injury Accelerates the Brain Death Cascade? Preliminary Results

Cited by 4 publications

References 6 publications

Letter: A Call to Action: A Neurosurgeon's Responsibility in Firearm Injury Prevention and Advocacy

Letter: A Call to Action: A Neurosurgeon's Responsibility in Firearm Injury Prevention and Advocacy

Firearm-Related Traumatic Brain Injury Homicides in the United States, 2000-2019

Organ Use Rate: A New Indicator of Donation and Transplantation Efficiency

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