Firearm injuries received in emergency room of a Nigerian Teaching Hospital: Analysis of pattern, morbidity, and mortality

Abstract

Background: The morbidity and mortality associated with civilian firearm injury in developing countries is appreciable. The increasing incidence of gunshot casualties received in hospital emergency rooms is an emerging concern. The aim of this study was to determine the pattern and outcome of firearm injuries in a civilian setting of a developing country.

Materials and Method: This was a retrospective analysis of data on the entire patients with firearm injury received in the emergency room of Federal Teaching Hospital Abakaliki from January 2005 to December 2014.

Results: There were 214 casualties, male-to-female ratio was 8:1, and mean age was 31.7 ± 0.80 years. The causes of injuries were armed robbery (59.9%), assault (33.6%), and accidental (6.5%). The incidence of armed robbery– related injury peaked in May and was higher in rainy season (P < 0.018), urban areas (P < 0.001) and at night-time (P < 0.033), whereas the incidence of assaultrelated injury peaked in April and was higher in dry season in rural areas and at day-time. Duration of hospital admission ranged from 1 to 184 days and mean was 16 days. Prolonged duration of hospital admission correlated with perforating wound (P < 0.001), high-velocity gunshot (P < 0.001), fractures (P < 0.001) and wound infection (P < 0.001). Preventable death rate was high, although mortality rate was 5.6%. A high mortality rate correlated with visceral injury (P < 0.001) and hypovolaemic shock (P < 0.001).

Conclusion: The temporal distribution of firearm injury varies in location and aetiology of gunshot. This and the factors for relatively high morbidity and preventable death rate observed call for preventive strategies as well as improvement in pre-hospital and emergency room care.

Keywords: Firearm, gunshot, injury, morbidity, mortality emergency room, Nigeria, pattern