Surviving the Shot: The Operative and Resource Burden of Abdominal Firearm Injury Survivorship

Abstract

Background

Abdominal nonfatal firearm injuries (NFIs) carry significant morbidity beyond initial life-saving interventions. The objective of this study was to demonstrate the extensive journey required for abdominal NFI at our institution and highlight the intensity of its survivorship.

Materials & Methods

This is a single-center retrospective review of NFIs at a level one academic trauma center, including patients from 2019 to 2021. IBM SPSS 29.0 was used for descriptive analysis and independent-samples t-tests. Inclusion criteria were patients with NFIs and abdominal NFIs. Fatal injuries were excluded.

Results

Of the 359 patients included in the study, 30.1% (n = 108) sustained an abdominal injury. Among those with abdominal NFI, 91.7% underwent surgery, and ultimately, 4.6% required a PEG, 21.3% an ostomy, and 2.8% a tracheostomy, with a mean of 2.34 trips to the operating room. Mean total cost of stay (TCOS) for patients with abdominal NFI was $55,205 (vs $28,497, P = .001). ICU TCOS was $10,863; total length of stay (LOS) was 12.23 days (vs 7.05, P = .001); ICU LOS was 6.84 days (vs 3.79, P = .047); trips to the OR averaged 2.34; and the number of follow-up visits attended was 3.62.

Discussion

Abdominal NFI survivorship represents a significant, resource-intensive trajectory that frequently extends beyond initial inpatient hospitalization. Our experience highlights the need for efficient, protocolized management algorithms and resource allocation that address the longitudinal care burden of abdominal NFIs.