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

Abstract

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.

Gunshot injuries: experience in a tertiary health facility in the Niger Delta Region of Nigeria

“…In contrast, studies by Singh et al . [ 5 ] from India and Norton et al . [ 28 ] from UK, reported homicidal assault as the main motive behind gunshot injuries in their studies.…”

“…In this study, the most affected persons (68%) were between ages 20 and 39 years. This finding is similar to what has been reported in several previous studies although percentages vary from study to study [ 5 , 16 , 18 , 22 , 23 , 26 , 29 , 30 ]. Government at all levels and all stake holders must therefore, make concerted efforts to reduce the incidence of GSI and mitigate its adverse effect on economic productivity and other economic and health indices.…”

“…The incidence of gunshot injuries (GSI) in civilian populations is on the rise worldwide with its attendant morbidity and mortality especially among the young and productive age groups in the society who are the ones most frequently affected. GSI has thus, become a global public health problem and a therapeutic challenge to surgeons [ 2 , 5 , 6 , 11 , 18 , 20 , 22 - 26 ]. Forty-one patients had GSI to various parts of the body over a period of 3 years in our study.…”

“…In addition, the human and material resources needed for the successful management of these injuries are enormous and constitute a significant drain on societal resources thus also negatively affecting the economy and the resources available for the treatment of other ailments. [ 5 , 6 , 12 , 17 , 19 , 20 ].…”

Assessment of Fatal Firearm Injuries in Cairo and Giza Governorate: Analytical Study (2014)

“…T his was in agreement with Jorgenson et al 9 in Oklahoma, who found that the most common cases is males (95%) between the ages of 20 and 39 (64%), Singh et al 10 in Uttar, who report ed Males (83.7%).…”