Abstract
Purpose
The purpose of the present study is to determine whether handguns discharged at the craniomaxillofacial region are associated with greater fatality in suicide attempts relative to shotguns.
Methods
The following retrospective cohort study was completed using the Nationwide Inpatient Sample (NIS), a Healthcare Cost and Utilization Project (HCUP) database. The primary predictor variable was the type of firearm (handguns vs. shotguns). The primary outcome variable was prognosis (fatality vs. no fatality). A binary logistic regression was performed to determine the risk of mortality of all predictor variables.
Results
Our final sample consisted of 223 patients. Handguns (85.2%) were the most popular firearm. Relative to black patients, white patients were over three times more likely to die (p < 0.05). Compared to patients who were transferred in, patients not transferred in were eight times more likely to die (p = 0.000). Relative to patients who were admitted electively, patients who were not admitted electively were 16.7 times more likely to die (p < 0.01). Finally, relative to patients who used shotguns, patients who used handguns were 3.4 times more likely to die (p = 0.002).
Conclusion
Self-inflicted gunshot wounds to the maxillofacial region by handguns were more lethal than shotguns.
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Data availability
The NIS is a publicly available all-payer inpatient healthcare database.
Code availability
ICD-10 codes are publicly available.
References
INTERNATIONAL A (2021) GUN VIOLENCE - KEY FACTS. https://www.amnesty.org/en/what-we-do/arms-control/gun-violence/. Accessed July 29, 2021
Digest Rs (2021) Gun Violence Statistics in the United States: 12 Charts You Need to See. https://www.rd.com/article/gun-violence-statistics/. Published 2021. Accessed July 19, 2021
Health NIoM (2021) Suicide. https://www.nimh.nih.gov/health/statistics/suicide#part_154971. Published 2021. Accessed July 19, 2021
Health HTHCSoP (2021) Lethality of suicide methods. https://www.hsph.harvard.edu/means-matter/means-matter/case-fatality/. Accessed July 19, 2021
Turgut K, Gur A, Guven T, Oguzturk H (2019) Evaluation of factors related to mortality caused by firearm injury: a retrospective analysis from Malatya Turkey. Arch Iran Med 22(2):80–84
Kucuker IST, Keles MK, Yosma E, Aksakal IA, Demir A (2016) Our treatment approaches in Ssvere maxillofacial injuries occurring after failed suicide attempts using long-barreled guns. J Craniofac Surg 2(27):e133–e138
Alper M, Totan S, Cankayali R, Songur E (1998) Gunshot wounds of the face in attempted suicide patients. J Oral Maxillofac Surg. 56(8):930–933 (discussion 933-934)
Yuksel F, Celikoz B, Ergun O, Peker F, Acikel C, Ebrinc S (2004) Management of maxillofacial problems in self-inflicted rifle wounds. Ann Plast Surg 53(2):111–117
Johnson J, Markiewicz MR, Bell RB, Potter BE, Dierks EJ (2012) Gun orientation in self-inflicted craniomaxillofacial gunshot wounds: risk factors associated with fatality. Int J Oral Maxillofac Surg 41(8):895–901
Stefanopoulos PK, Soupiou OT, Pazarakiotis VC, Filippakis K (2015) Wound ballistics of firearm-related injuries–part 2: mechanisms of skeletal injury and characteristics of maxillofacial ballistic trauma. Int J Oral Maxillofac Surg 44(1):67–78
Kaufman EJ, Morrison CN, Branas CC, Wiebe DJ (2018) State firearm laws and interstate firearm deaths from homicide and suicide in the United States: a cross-sectional analysis of data by county. JAMA Intern Med 178(5):692–700
Fonseca RJ, et al (2013) Oral & maxillofacial trauma, 4th edn. Saunders, St. Louis, MO
Sherman RT, Parrish RA (1963) Management of shotgun injuries: a review of 152 cases. J Trauma 3:76–86
Miller GF, Kegler SR, Stone DM (2020) Traumatic brain injury-related deaths from firearm suicide: United States, 2008–2017. Am J Public Health 110(6):897–899
Pew Research Center (2017) 1. The demographics of gun ownership. https://www.pewresearch.org/social-trends/2017/06/22/the-demographics-of-gun-ownership/. Published 2017. Accessed 21 July 2021
MEATEATER (2019) IS HUNTING TOO WHITE? https://www.themeateater.com/hunt/big-game/is-hunting-too-white. Published 2019. Accessed 20 July 2021
Friedlander AH, Rosenbluth SC, Rubin RT (2012) The adult suicide-prone patient: a review of the medical literature and implications for oral and maxillofacial surgeons. J Oral Maxillofac Surg 70(5):1253–1260
Centers for Disease Control and Prevention (2021) WISQARS™ — Web-based injury statistics query and reporting system. https://www.cdc.gov/injury/wisqars/index.html. Accessed 21 July 2021
McLoughlin RJ, Hazeltine M, Dacier BM, Hirsh MP, Cleary MA, Aidlen JT (2019) Young lives cut short: the relationship between firearms and pediatric suicide. J Trauma Acute Care Surg 87(1):161–167
Schnitzer PG, Dykstra HK, Trigylidas TE, Lichenstein R (2019) Firearm suicide among youth in the United States, 2004–2015. J Behav Med 42(4):584–590
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Stanbouly, D., Chuang, SK. Self-inflicted craniomaxillofacial gunshot wounds by handguns are more deadly than those by shotguns: an NIS study. Oral Maxillofac Surg 27, 79–87 (2023). https://doi.org/10.1007/s10006-021-01028-9
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DOI: https://doi.org/10.1007/s10006-021-01028-9