Spectrum of Gunshot Injuries in Civilian Practice at a Tertiary Hospital in a Semi-rural Community in Nigeria

Abstract

Background: Gunshot injuries are common. Political and ethno-religious conflicts have made injuries from ballistics now commonplace in Nigeria. Data was collected prospectively at Federal Medical Centre Owo, South Western Nigeria from September 2007 to August 2011. The objective was to highlight the nature of gunshot wounds, patients’ and gun  characteristics, and document the outcome of treatment upon discharge.
Methods: All patients with gunshot injuries (GSI) admitted via the emergency room (ER) of the hospital. Outcome measures included the status upon leaving the hospital: Alive and discharged home without disability; alive and discharged home with some disability; discharged against medical advice; referral to another hospital and death. Data was analyzed using SPSS17 program
for frequencies, measure of central tendencies and relationships.
Results: A total of 139 patients were seen. Males accounted for 94.2% of the victims. The ages ranged from 12 to 70 years (mean = 33.14 years); modal age group was 21-40 years (76.3%). High velocity injuries were common (59%). Armed robbery (56.1%), accidental discharge (20.1%) and assault (11.5%) were major sources. Injuries involved the limbs (54.7%), trunk (10.1%), and > one region (22.3%). About 62% of cases presented within 8hours of injury. The mortality and limb deformity rates were 5.8% and 14.4% respectively. Outcome of treatment depended on promptness of definitive care and the nature of injuries at presentation (p= 0.001 and p=0.026 respectively).
Conclusion: Injuries from high velocity guns were common. Armed robbery, assault and accidental discharge from law enforcement agents were the major sources. Outcome was dependent on the nature of injuries and the promptness of intervention.

Keywords: Injuries, Civilian, Gunshot,