3192.0: Monday, November 13, 2000 - 5:15 PM

Abstract #4637

Functional outcome following firearm injury

Arlene I. Greenspan, DrPH, PT, Department of Rehabilitation Medicine, Emory University, 1441 Clifton Road, NE, Atlanta, GA 30322, 404-712-5674, agreens@emory.edu and Arthur L. Kellermann, MD, MPH, Department of Emergency Medicine, Emory University, 1518 Clifton Road, Atlanta GA, GA 30322.

In the U.S., approximately 100,000 persons are injured and 38,000 more die annually from firearm injuries at a lifetime medical cost of $2.1 billion. Despite this huge public health burden, little is known about long-term outcomes from such injuries. We conducted a follow-up of patients treated at a Level I trauma center. Subjects were interviewed in the hospital regarding demographic and pre-injury characteristics, including health status. Subjects were re-interviewed 8 months post-discharge regarding post-injury health status, symptoms of post-traumatic stress (PTSS) and changes in pre-injury characteristics. The nature and severity of injuries were abstracted from medical records. Of 106 patients enrolled in the study, 60 were interviewed 8 months post-discharge. Subjects were predominantly young (mean age 30 years), male (92%), and African-American (95%). Injuries were overwhelmingly assault-related (98%). Health status was measured using the SF-36. Mean SF-36 scores at 8 months were significantly worse than pre-injury scores for all subscales (p<.05). Differences were greatest for health perceptions, role physical, physical function, social functioning, bodily pain, and energy/fatigue (p<.001). Forty-three percent demonstrated severe post-traumatic stress symptoms (PTSS) as measured by the Impact of Event Scale. Mental health subscores were lowest for subjects with severe PTSS. Physical health subscores were lowest for subjects with lower extremity or central nervous system injuries. Admission Injury Severity Scores were not predictive of 8-month SF-36 scores. These data suggest that persons who survive firearm injuries demonstrate significant long-term physical and mental health disabilities. Furthermore, traditional severity measures may not be predictive of long-term disability or functional outcomes

Learning Objectives: At the conclusion of the session the participant in this session will be able to: 1. Describe the nature and severity of injuries, as well as the demographic, psychosocial, and economic characteristics of patients treated in an inner-city trauma center for firearm injuries. 2. Characterize the types of long-term disabilities associated with firearm injury. 3. Identify two risk factors associated with poor long-term health status following firearm injury

Keywords: Firearms, Disability

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 128th Annual Meeting of APHA