Gunshot survivors face mental, physical challenges toward recovery

Firearm injuries affect victims far beyond mortality and economic burden, according to results of a prospective cohort study published in JAMA Surgery.

“Although contacting survivors of [gunshot wounds] several years after injury proved difficult, our results indicate that survivors experience long-term physical and psychological outcomes years after being shot,” Michael A. Vella, MD, of the division of traumatology, surgical critical care and emergency surgery at the University of Pennsylvania’s Perelman School of Medicine, and colleagues wrote. “Furthermore, our results suggest a role for the initiation of long-term longitudinal care to improve physical, mental and emotional recovery after firearm injury.”

According to the researchers, there are 70,000 annual survivors of gunshot wounds in the United States, but few studies have evaluated this population. To address this research gap, they assessed patient-reported outcomes among 183 gunshot wound survivors between 2008 and 2017 at an urban level one trauma center. The median participant age was 27 years, and most (91.8%) were black men. Prior to the gunshot wound, 76% were employed vs. 62.1% post-gunshot wound. Following the wound, combined alcohol and substance use increased by 13.2%. Participants’ mean scores for Global Physical Health, Global Mental Health and Physical Function PROMIS metrics were below population norms, and 48.6% screened positive for probable PTSD. Those admitted to the ICU had worse mean Physical Function scores than those not admitted. At 5 years or less after injury, participants had greater risk for PTSD but better mean Global Physical Health Scores than those more than 5 years after injury.

“A deeper understanding of the long-term outcomes of firearm injuries is needed to provide more appropriate and tailored care to this unique patient population,” the researchers wrote.

In a related editorial, Rochelle A. Dicker, MD, of the department of surgery at the University of California, Los Angeles’ Geffen School of Medicine, and Laurie J. Punch, MD, of the department of surgery at Washington University School of Medicine in St. Louis, emphasized the importance of tailoring treatment to the specific needs of gunshot wound survivors.

“By tuning into the patient experience, trauma care avails itself of a unique insight, allowing for scholarship toward a more complete treatment of firearm violence within individuals and communities,” they wrote. “The voice of the victim is instrumental in providing the path to recovery for those whose lives have been touched by bullets.” – by Joe Gramigna

Disclosures: Dicker, Punch and Vella report no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.