Racial equity in trauma injury: An unresolved enigma

Krzeczowski, Rachel M; Villalta, Cesar; Verner, Heather M Grossman; Bradley, Sarah; Subramanian, Shyam; Amos, Joseph Darryl

doi:10.1016/j.amjsurg.2023.05.022

Cited by 2 publications

(2 citation statements)

References 16 publications

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“…The demographic results of our study found older, white males to be most likely to have self-inflicted GSWs and younger, non-white males to have non-self-inflicted GSWs. This is consistent with previous studies evaluating the epidemiology of SI versus NSI GSWs [ 3 , 5 , 7 , 9 ]. Further, we found that SI GSWs were most likely to occur in manual workers, while NSI GSWs were most likely to occur in retired/unemployed individuals.…”

Section: Discussionsupporting

confidence: 93%

“…Further, we found that SI GSWs were most likely to occur in manual workers, while NSI GSWs were most likely to occur in retired/unemployed individuals. However, a recent study by Krzeczowski et al examined the racial disparity and was unable to attribute it to population demographics or socioeconomic status, indicating a need to further investigate this correlation [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of Self-Inflicted versus Non-Self-Inflicted Gunshot Wounds and Associated Injuries Involving the Hand and Upper Extremity

Pan,

Giuffrida,

Trivedi

et al. 2024

Healthcare

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Orthopedic costs associated with gunshot wounds (GSWs) totaled approximately USD 510 million from 2005 to 2014. Previous studies have identified differences in injuries associated with self-inflicted (SI) GSWs; however, there remains a gap in understanding injury patterns. This study aims to expand upon the current literature and shed light on injury patterns and outcomes associated with SI vs. non-self-inflicted (NSI) GSWs. This is a retrospective cohort study of upper extremity GSWs from January 2012 to December 2022. Data were analyzed using the two-sample t-test, Pearson’s chi-squared test, and Fisher’s exact test. SI GSWs tended to be high-velocity GSWs and occurred more often in distal locations compared to NSI GSWs (p = 0.0014 and p < 0.0001, respectively). SI GSWs were associated with higher Gustilo–Anderson (GA) and Tscherne classifications (p < 0.0001 and p = 0.0048, respectively) and with a greater frequency of neurovascular damage (p = 0.0048). There was no difference in fracture rate or need for operative intervention between the groups. GA and Tscherne classifications were associated with the need for and type of surgery (p < 0.0001), with a higher classification being associated with more intricate operative intervention; however, GSW velocity was not associated with operative need (p = 0.42). Our findings demonstrate that velocity, wound grading systems, and other factors are associated with the manner in which GSWs to the upper extremity are inflicted and may thus have potential for use in the prediction of injury patterns and planning of trauma management and surgical intervention.

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