TY  - JOUR
PY  - 2023//
TI  - The cost of gun shot wounds to the head: an unevenly distributed burden
JO  - World neurosurgery
A1  - Schoen, Nathan
A1  - Matichak, David
A1  - Armstrong, Valerie
A1  - Sedighim, Shaina
A1  - Lew, Emma
A1  - Jagid, Jonathan
A1  - Bullock, M. Ross
A1  - Richardson, Angela
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - INTRODUCTION: Despite the significant clinical consequences and socioeconomic costs of gun-shot wounds to the head (GSWH), studies examining pre-hospital risk factors, geo-spatial patterns, and economic cost are lacking. <br><br>METHODS: A retrospective analysis was performed for GSWH patients (single or multiple injuries) presenting to the level one Ryder Trauma Center (hospital patients) as well as the Miami Dade County Medical Examiner (ME) Department, from October 2013 to October 2015. Additionally, ME data was queried from the previous decade (2008-2017) to analyze longitudinal trends. <br><br>RESULTS: 402 consecutive cases met inclusion criteria: 297 (74%) presented to the ME and 105 (26%) presented to the hospital. GSWH in our cohort had a case fatality rate of 89%, predominantly afflicting males, Caucasians, and victims of suicide, with a mean age of 41.9 ± 20.6 years. Hospital patients were more likely to be Black males from low socioeconomic (SES) regions involved in assault. Older, Caucasian males were overrepresented in patients attempting and completing suicide, thus comprised a higher percentage of ME cases. Geo-spatial analysis of hospital patient injury zip-codes illustrates GSWH are significantly clustered in low-income urban centers with greater poverty rates. In Miami-Dade County, the economic burden of GSWH, as measured by total healthcare costs and lifetime productivity losses, was estimated to be $11,867,415 and $246,179,498 respectively. <br><br>CONCLUSION: In the first analysis of GSWH with the inclusion of both hospital and ME data in a representative urban setting, our findings demonstrate pre-hospital risk factors and the unequal distribution of the significant economic costs of GSWH.<p />  <p>Language: en</p>
LA  - en
SN  - 1878-8750
UR  - http://dx.doi.org/10.1016/j.wneu.2022.12.130
ID  - ref1
ER  -