Cripps Michael W, Ereso Alexander Q, Sadjadi Javid, Harken Alden H, Victorino Gregory P
Department of Surgery, University of California San Francisco, East Bay, Alameda County Medical Center, Oakland, California 94602, USA.
Am Surg. 2009 Jan;75(1):44-7; discussion 48.
It is presumed that as the number of gunshot wounds (GSWs) increases, so do the Injury Severity Score (ISS) and mortality risk. We hypothesized that the number of bullet wounds relates to ISS and death; however, a single GSW to the head is ominous. We reviewed the charts of all GSW patients admitted to a trauma center from 2004 to 2006 (n = 531). We analyzed patient demographics, ISS, and mortality. There was no correlation with the number of GSWs with either ISS or mortality. There was only a 0.3 per cent increased risk of death for each additional GSW (r2 = 0.12). Patients with a single GSW versus multiple GSWs had no difference in mortality (9.1 vs 8.4%, P = 0.8). A single GSW to the head carried a 50 per cent mortality risk. For those who sustained both head and body GSWs, each additional GSW did not increase mortality (r2 = 0.007). Our study shows that the number of GSWs has no affect on mortality or ISS. Internal triage and management of gunshot victims should not be affected by the categorization of patients as having a single versus multiple GSWs.
据推测，随着枪伤（GSW）数量的增加，损伤严重度评分（ISS）和死亡风险也会增加。我们假设枪伤数量与ISS及死亡相关；然而，头部单发GSW则预后凶险。我们回顾了2004年至2006年收治于一家创伤中心的所有GSW患者的病历（n = 531）。我们分析了患者的人口统计学资料、ISS及死亡率。GSW数量与ISS或死亡率均无相关性。每增加一处GSW，死亡风险仅增加0.3%（r2 = 0.12）。单发GSW患者与多发GSW患者的死亡率无差异（9.1%对8.4%，P = 0.8）。头部单发GSW的死亡风险为50%。对于头部和身体均有GSW的患者，每增加一处GSW并不会增加死亡率（r2 = 0.007）。我们的研究表明，GSW数量对死亡率或ISS没有影响。枪伤受害者的内部分诊和管理不应受患者被分类为单发或多发GSW的影响。
