Nicholas Christina M, Ward Jeanette G, Helmer Stephen D, Haan James M
University of Kansas School of Medicine-Wichita, Department of Surgery, Wichita, KS.
Abrazo Community Health Network, Abrazo West Campus, Department of Trauma Services, Goodyear, AZ.
Kans J Med. 2020 Feb 28;13:38-42. eCollection 2020.
This study examined the incidence of gunshot wounds before and after enacting a conceal carry (CC) law in a predominately rural state.
A retrospective review was conducted of all patients who were admitted with a gunshot injury to a Level I trauma center. Patient data collected included demographics, injury details, hospital course, and discharge destination.
Among the 238 patients included, 44.6% (n = 107) were admitted during the pre-CC period and 55.4% (n = 131) in the post-CC period. No demographic differences were noted between the two periods except for an increase in uninsured patients from 43.0% vs 61.1% (p = 0.020). Compared to pre-CC patients, post-CC patients experienced a trend toward increased abdominal injury (11.2% vs 20.6%, p = 0.051) and increased vascular injuries (11.2% vs 22.1%, p = 0.026) while lower extremity injuries decreased significantly (38.3% vs 26.0%, p = 0.041). Positive focused assessment with sonography in trauma (FAST) exams (2.2% vs 16.8, p < 0.001), intensive care unit admission (26.2% vs 42.0%, p = 0.011) and need for ventilator support (11.2% vs 22.1%, p = 0.026) all increased during the post-CC period. In-hospital mortality more than doubled (8.4% vs 18.3%, p = 0.028) across the pre- and post-CC time periods.
Implementation of a CC law was not associated with a decrease in the overall number of penetrating injuries or a decrease in mortality.
本研究调查了在一个以农村为主的州实施隐蔽携带(CC)法前后枪伤的发生率。
对所有因枪伤入住一级创伤中心的患者进行回顾性研究。收集的患者数据包括人口统计学资料、损伤细节、住院过程及出院去向。
纳入的238例患者中,44.6%(n = 107)在CC法实施前入院,55.4%(n = 131)在CC法实施后入院。除未参保患者比例从43.0%增至61.1%(p = 0.020)外,两个时期的人口统计学特征无差异。与CC法实施前的患者相比,CC法实施后的患者腹部损伤有增加趋势(11.2%对20.6%,p = 0.051),血管损伤增加(11.2%对22.1%,p = 0.026),而下肢损伤显著减少(38.3%对26.0%,p = 0.041)。创伤超声重点评估(FAST)检查阳性率(2.2%对16.8%,p < 0.001)、重症监护病房入住率(26.2%对42.0%,p = 0.011)和呼吸机支持需求率(11.2%对22.1%,p = 0.026)在CC法实施后均增加。CC法实施前后住院死亡率增加了一倍多(8.4%对18.3%,p = 0.028)。
CC法的实施与穿透伤总数的减少或死亡率的降低无关。