Epidemiology, demographics, and outcomes of craniomaxillofacial gunshot wounds in a level I trauma center.
BACKGROUND
Gunshot injuries to the craniomaxillofacial region are a challenge to the trauma and reconstructive surgeon. Although management of these injuries has been standardized and early rather than late intervention is advocated, the patient characteristics before, during, and after have been poorly elucidated.


METHODS
A prospectively maintained Level I trauma center database was queried as to gunshot wounds of the craniomaxillofacial skeleton. Over a five-year period (2007-2011), 168 patients were identified with these injuries. Charts were reviewed as to demographics, presentations, and outcomes and these were tested for significant relationships with hospital length of stay, numbers and types of procedures, morbidity, and mortality.


RESULTS
Gunshot wounds to the craniofacial skeleton resulted in 71 deaths in this patient population. Those that died were significantly older, presented with a lower GCS, had a shorter LOS, and a higher INR than those that lived. Subgroup analysis of mechanism demonstrated mortality was more likely to occur as a result of self-inflicted injury in whites and due to assault in the African-American population.


CONCLUSIONS
Data gathered from this study disputes some commonly held beliefs regarding the epidemiology of gunshot injuries and should allow for better characterization of which outcomes are consistent with which presentations.
From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Indiana University Health, 705 Riley Hospital Drive, RI 2514, Indianapolis, IN 46202, USA. Electronic address: stholpad@iupui.edu.
Sunil S
SS
Tholpady
From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Indiana University Health, 705 Riley Hospital Drive, RI 2514, Indianapolis, IN 46202, USA.
Patrick
P
DeMoss
From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Indiana University Health, 705 Riley Hospital Drive, RI 2514, Indianapolis, IN 46202, USA.
Kariuki P
KP
Murage
From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Indiana University Health, 705 Riley Hospital Drive, RI 2514, Indianapolis, IN 46202, USA.
Robert J
RJ
Havlik
From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Indiana University Health, 705 Riley Hospital Drive, RI 2514, Indianapolis, IN 46202, USA.
Roberto L
RL
Flores
D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000367:Age Factors; D016021:Epidemiologic Studies; D005147:Facial Bones / Q000293:injuries*; D005151:Facial Injuries / Q000453:epidemiology*; D005260:Female; D005389:Firearms / Q000145:classification; D015600:Glasgow Coma Scale; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007196:Indiana / Q000453:epidemiology; D019934:International Normalized Ratio; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012886:Skull / Q000293:injuries*; D013405:Suicide / Q000706:statistics & numerical data; D016896:Treatment Outcome; D014754:Violence / Q000706:statistics & numerical data; D044465:White People / Q000706:statistics & numerical data; D014948:Wounds, Gunshot / Q000453:epidemiology* / Q000401:mortality; D055815:Young Adult
Craniofacial trauma; Epidemiology; Gunshot wounds