Gunshot Injuries of the Hand: Incidence, Treatment Characteristics, and Factors Associated With Healthcare Utilization. (January 2023)

• Record Type: Journal Article
• Authors: Anantavorasakul, Navapong; Westenberg, Ritsaart F.; Serebrakian, Arman T.; Zamri, Meryam; Chen, Neal C.; Eberlin, Kyle R.
• Is Part Of: Hand. Volume 18:Number 1(2023)
• Page Start: 158
• Page End: 166
• Publication Date: 2023-01
• Subjects: gunshot -- gunshot injury -- healthcare utilization -- hand -- anatomy -- GSI -- firearm; Hand -- Surgery -- Periodicals; Hand -- Surgery; Periodicals; 617.57005
• DOI: 10.1177/1558944721998016
• Languages: English
• ISSNs: 1558-9447

Abstract

Background: The objectives of this study are to: (1) describe the demographics, injury patterns, and treatment characteristics of patients who sustained a gunshot injury (GSI) of the hand; and (2) examine the utilization of healthcare resources in patients with a GSI of the hand. Methods: We retrospectively identified 148 adult patients who were treated for a GSI of the hand between January 2000 to December 2017 using multiple International Classification of Diseases Ninth and Tenth Edition (ICD-9 and ICD-10) codes. We used bivariate and multivariable analysis to identify which factors are associated with unplanned reoperation, length of hospitalization, and number of operations. Results: Multivariable logistic regression showed that fracture severity was associated with unplanned reoperation. Multivariable linear regression showed that fracture severity is associated with a higher number of hand operations after a GSI of the hand, and that a retained bullet (fragment) and patients having gunshot injuries in other regions than the hand had a longer length of hospitalization. Seventy (47%) patients had sensory or motor symptoms in the hand after their GSI, of which 22 (15%) patients had a transection of the nerve. Conclusions: Sensory and motor nerve deficits are common after a GSI of the hand. However, only 31% of patients with symptoms had a transection of the nerve. A retained bullet (fragment), having more severe hand fractures, and GSI in other regions than the hand are associated with a higher number of operation and a longer period of hospitalization.