title: Civilian gunshot wounds--outpatient management.
abstract: Cost containment is important in this time of inner-city economic and health-care crisis. Of 28,150 patients treated for gunshot wounds (GSWs) from 1977 through 1991, 16,892 (60%) were treated as outpatients after emergency department evaluation and treatment. The complication rate was 1.8% (mostly infections), and nine patients were later found to have vascular injuries requiring surgical treatment. These were identified later at outpatient follow-up and treated with no long-term morbidity or mortality. A conservative estimate of the cost savings from this study was more than $37 million. With a more liberal use of angiography to eliminate rare missed vascular injuries, many GSW victims can be safely treated as outpatients, eliminating the need for expensive in-hospital observation.
authors.affiliation: Department of Emergency Medicine, Martin Luther King, Jr. General Hospital, Los Angeles, CA.
authors.forename: G J
authors.initials: GJ
authors.lastname: Ordog
authors.forename: J
authors.initials: J
authors.lastname: Wasserberger
authors.forename: S
authors.initials: S
authors.lastname: Balasubramanium
authors.forename: W
authors.initials: W
authors.lastname: Shoemaker
mesh_terms: D000328:Adult; D000553:Ambulatory Care / Q000191:economics*; D000792:Angiography; D017046:Cost Savings; D004636:Emergency Service, Hospital / Q000191:economics / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006302:Health Services Research; D017721:Hospital Costs; D006801:Humans; D015141:Los Angeles / Q000453:epidemiology; D008297:Male; D012189:Retrospective Studies; D015599:Trauma Severity Indices; D016896:Treatment Outcome; D014948:Wounds, Gunshot / Q000145:classification / Q000191:economics* / Q000628:therapy*