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Journal Article

Citation

Rolle ML, McLellan RM, Nanda P, Patel AB, Sacks CA, Masiakos PT, Stapleton CJ. Neurohospitalist 2022; 12(3): 444-452.

Copyright

(Copyright © 2022, SAGE Publishing)

DOI

10.1177/19418744221077552

PMID

35755225

PMCID

PMC9214932

Abstract

OBJECTIVE: To assess the clinical, racial, and social characteristics of victims of Gunshot wounds (GSWs) to the head and assess for associations between these factors and outcomes. SUMMARY BACKGROUND DATA: Previous literature has not focused on the association of race and socioeconomic factors with these specific injuries.

METHODS: We identified patients with GSWs to the head who presented to 2 urban academic medical centers between 1998 and 2020, and extracted patient-level demographic data, information about the clinical and surgical course, and outcomes at discharge and follow-up.

RESULTS: The cohort included 250 patients, 90% (n = 226) of whom were male, with a mean age of 28 years. Forty-five percent were white (n = 112), 19% Black (n = 48), 18% Latinx (n = 45), with 6% "other" (n = 16), and 12% "unknown" (n = 29). The majority of patients presented with assault-related trauma (n = 153, 61%) as compared to self-inflicted injuries (n = 97, 39%). Across the entire cohort, sex, age, race, and median income by ZIP code were not significant predictors of outcome. Victims of assault by GSW to the head were more likely to be age 18 or younger (OR 5.26, P = 0.01), between the ages of 19 and 33 years (OR 4.7, P = 0.001), Black (OR 6.66, P <.001), and Latinx (OR 2.65, P = 0.03). Most patients (n = 155, 63%) had a poor functional outcome (modified Rankin Score 3-6) at discharge.

CONCLUSION: Age, race, and income status were not independent predictors of mortality or functional outcome at discharge in our population. Assault-related GSWs to the head mostly involved young Black or Latinx men of lower socioeconomic status, while self-inflicted injuries were largely seen in older white men.


Language: en

Keywords

health disparities; traumatic brain injury; gunshot wounds; social determinants

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