A structured autopsy-based audit of 370 firearm fatalities: Contribution to inform policy decisions and the probability of the injured arriving alive at a hospital and receiving definitive care.
The objectives of this autopsy-based audit of firearm-related fatalities were to acquire data to inform policy decisions and to assess the probability of the injured arriving alive at a hospital and receiving definitive care.
Demographics; co-morbidities; location and intention of the injury; toxicology; types of firearms; Abbreviated Injury Scale; Injury Severity Score (ISS); transfer means and time; and location of death.


RESULTS
Of a total of 370 fatalities, 85.7% were male. The median age was 38 (9-95) years. Suicides (47%) and assaults (45.1%) were the most common underlying intentions. The most seriously injured regions were the head (44.5%), thorax (25.7%), abdomen (10.7%), and spine (5.7%). Of the 370 total subjects, 4.9% had an ISS<16 and 59.5% had an ISS≤74; both groups were classified as potentially preventable deaths. The majority (84%) died at the scene, and only 9.8% left the emergency department alive for further treatment. Multivariate analyses documented that postmortem ISS is an independent factor that predicts the probability of the injured reaching a hospital alive and receiving definitive care. Individuals injured in greater Athens and those most seriously injured in the face, abdomen or spine had significantly greater chances of reaching a hospital alive and receiving definitive care, whereas those injured by a shotgun and the positive toxicology group were significantly less likely to. In conclusion, this study provides data to inform policy decisions, calls for a surveillance network and establishes a baseline for estimating the probability regarding the location of firearm-related deaths.
National & Kapodistrian University of Athens, University General Hospital Attikon, Fourth Surgery Department, 1 Rimini Street, 124 62 Athens, Greece. ipapado@med.uoa.gr
Iordanis N
IN
Papadopoulos
Nikolaos K
NK
Kanakaris
Nikolaos
N
Danias
Dimitrios
D
Sabanis
George
G
Konstantudakis
Spyridon
S
Christodoulou
Yiannis C
YC
Bassiakos
Christos
C
Leukidis
D015998:Abbreviated Injury Scale; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000374:Aggression; D001344:Autopsy; D002648:Child; D015897:Comorbidity; D005260:Female; D006291:Health Policy; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D011336:Probability; D013405:Suicide / Q000706:statistics & numerical data; D014754:Violence / Q000706:statistics & numerical data; D014948:Wounds, Gunshot / Q000401:mortality*