TY  - JOUR
PY  - 2021//
TI  - Survival following self-inflicted gunshot injuries to the face using the National Trauma Data Bank
JO  - Journal of cranialfacial surgery
A1  - Wasicek, Philip J.
A1  - Kantar, Rami S.
A1  - Yoon, Joshua
A1  - Elegbede, Adekunle
A1  - Nam, Arthur J.
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - INTRODUCTION: Self-inflicted gunshot wounds to the face frequently result in devastating injuries; however, there is a paucity of large experiences describing determinants of mortality and outcomes. <br><br>METHODS: Using the National Trauma Databank from 2007 to 2015, patients suffering self-inflicted firearm facial injuries were included. <br><br>RESULTS: Over 9 years 7869 patients were included: 87.7% were male, 46.4% suffered traumatic brain injury (TBI) and overall in-hospital mortality was 44.7%. The majority (67.8%) of in-hospital mortality occurred within the first 24 hours. Using multiple regression, advanced age (>65 years), presence of TBI, admission hypotension, and decreased Glasgow coma score were each independently associated with increased odds of mortality (all P < 0.001). Mandible or combined mandible/midface fracture injury patterns were most likely to survive (P < 0.001). Of those surviving to hospital discharge, the median [interquartile range] length of stay was 13 [6, 23] days, 86.6% required an intensive care unit stay with 67% requiring intubation and 42.5% tracheostomy. Among survivors, the combined mandible and midface fracture pattern resulted in the highest rates of tracheostomy (70.5%), gastrostomy tube placement (50.5%), and facial operations (87.0%) with a median [interquartile range] of 5 [3, 7] operative trips (all P < 0.001). <br><br>CONCLUSIONS: Self-inflicted facial firearm injuries are highly morbid injuries with the majority of in-hospital deaths occurring the first hospital day. Differences including concomitant TBI, facial injury pattern, neurologic status, and presence of hypotension on admission were independently associated with survival/death. More extensive facial injuries (combined mandible and midface fracture patterns) were more likely to survive and required more intensive interventions.<p />  <p>Language: en</p>
LA  - en
SN  - 1049-2275
UR  - http://dx.doi.org/10.1097/SCS.0000000000007634
ID  - ref1
ER  -