title: Gunshot wounds: 10-year experience of a rural, referral trauma center.
abstract: The 10-year experience of a Level II trauma center with 122 gunshot wounds referred from a large rural area was analyzed to illustrate differences from the experience of urban centers. Most frequent causes of injury were attempted suicide in 38 (31%) patients, hunting mishaps in 32 (26%), unintentional accidents in 29 (24%), and intentional assault in 18 (15%). Of weapons specified, rifles were documented in 48 (39%) instances, shotguns in 25 (21%), and handguns in 24 (20%). Body regions injured were the trunk in 47 (39%) patients, head in 35 (29%), lower extremity in 31 (25%), and upper extremity in 29 (24%). Twenty-five patients (20%) died as a result of their injuries. The cause of death was brain injury in 18 (72%), exsanguination from truncal wounds in 5 (20%), myocardial infarction in 1 (4%), and multiple organ failure in 1 (4%). We conclude that the distributions of cause and type of gunshot wounds are unique in a rural setting. These differences have profound consequences in designing effective prevention programs for our area and support the design of more efficient trauma systems for rural North America.
authors.affiliation: Department of Surgery, Gundersen Clinic, Ltd., La Crosse, Wisconsin 54601.
authors.forename: G G
authors.initials: GG
authors.lastname: Dodge
authors.forename: T H
authors.initials: TH
authors.lastname: Cogbill
authors.forename: G J
authors.initials: GJ
authors.lastname: Miller
authors.forename: J
authors.initials: J
authors.lastname: Landercasper
authors.forename: P J
authors.initials: PJ
authors.lastname: Strutt
mesh_terms: D000059:Accidents; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D005389:Firearms; D006801:Humans; D007223:Infant; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000601:surgery; D012017:Referral and Consultation; D012189:Retrospective Studies; D012424:Rural Population; D013406:Suicide, Attempted; D013997:Time Factors; D014193:Trauma Centers; D014754:Violence; D014922:Wisconsin; D014948:Wounds, Gunshot / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000601:surgery