Isolated extremity gunshot wounds cause a significant number of deaths annually despite exsanguinating extremity haemorrhage being potentially treatable and thus the deaths preventable. We sought to compare differences between children and young adult decedents of isolated extremity gunshot wounds to decedents from other-site gunshot wounds in terms of demographics, incident circumstances and disposition.
A retrospective analysis of the National Violent Death Reporting System database was performed for the years 2012–2021. Extremity gunshot wound decedents were compared with other-site gunshot wound decedents in patients 0–24 years old. Variables analysed included race, sex, incident, emergency medical services response, transportation to the emergency department and survival times. Analysis was conducted using bivariate inferential statistics: 2 and Wilcoxon rank-sum.
Of 40 746 firearm injuries, 39 878 (97.9%) were other-site gunshot wound decedents and 868 (2.1%) were extremity gunshot wound decedents. Black individuals comprised the majority of both cohorts but more commonly extremity gunshot wound decedents (75.3% vs 66.6%, p<0.0001). More extremity gunshot wound decedents were male (90.3% vs 87.1%, p=0.006) and in single homicides (89.9% vs 86.1%, p=0.0001). Both groups were admitted to the hospital at similar rates (12.1% vs 12.8%, p=0.34). 72.0% extremity gunshot wound decedents survived minutes after injury and 20.9% survived hours. A subgroup analysis was performed for decedents <18 years old and mirrored these trends.
This national analysis demonstrated disparities in race and sex among young decedents of isolated extremity gunshot wounds compared with other-site gunshot wounds. One-fifth of decedents with extremity gunshot wounds survived hours. Targeted intervention programmes such as Stop the Bleed training may help to improve survival of isolated extremity gunshot wounds.
IV.