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Multicenter Study
Patient-reported Outcomes at 6 to 12 Months Among Survivors of Firearm Injury in the United States.
- Juan Pablo Herrera-Escobar, Elzerie de Jager, Justin Conrad McCarty, Stuart Lipsitz, Adil H Haider, Ali Salim, and Deepika Nehra.
- Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, MA.
- Ann. Surg. 2021 Dec 1; 274 (6): e1247-e1251.
ObjectiveAssess outcomes in survivors of firearm injuries after 6 to 12 months and compared them with a similarly injured trauma population.BackgroundFor every individual in the United States who died of a firearm injury in 2017, three survived, living with the burden of their injury. Current firearm research largely focuses on mortality and short-term health outcomes, while neglecting the long-term consequences.MethodsWe contacted adult patients with a moderate-to-severe injury from a firearm or motor vehicle crash (MVC) treated at 3 level I trauma centers in Boston between 2015 and 2018. Patients were contacted 6 to 12 months postinjury to measure: presence of daily pain; screening for post-traumatic stress disorder (PTSD); new functional limitations; return to work; and physical and mental health-related quality of life. We matched each firearm injury patient to MVC patients using Coarsened Exact Matching. Adjusted Generalized Linear Models were used to compare matched patients.ResultsOf 177 eligible firearm injury survivors, 100 were successfully contacted and 63 completed the study. Among them, 67.7% reported daily pain, 53.2% screened positive for PTSD, 38.7% reported a new functional limitation in an activity of daily living, and 59.1% have not returned to work. Compared with population norms, overall physical and mental health-related quality of life was significantly reduced among firearm injury survivors. Compared with matched MVC survivors (n = 255), firearm injury survivors were significantly more likely to have daily pain [adjusted odds ratio (OR) 2.30, 95% confidence interval (CI) 1.08-4.87], to screen positive for PTSD (adjusted OR 3.06, 95% CI 1.42-6.58), and had significantly worse physical and mental health-related quality of life.ConclusionsThis study highlights the need for targeted long-term follow-up care, physical rehabilitation, mental health screening, and interventions for survivors of firearm violence.Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.
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