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German Congress of Orthopaedics and Traumatology (DKOU 2022)

25. - 28.10.2022, Berlin

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Gunshot injuries in Central Europe. Epidemiology, management and outcome in Germany, Switzerland and Austria – an analysis based on the TraumaRegister DGU®

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  • presenting/speaker Julian Scherer - Universitäts Spital Zürich, Klinik für Traumatologie, Zürich, Switzerland
  • Kai Oliver Jensen - Universitätsspital Zürich, Klinik für Traumatologie, Zürich, Switzerland
  • Arnold Suda - AUVA Unfallkrankenhaus Salzburg, Abteilung für Orthopädie und Traumatologie, Medizinische Fakultät Mannheim der Universität Heidelberg, Salzburg, Austria
  • Erwin Kollig - Bundeswehrkrankenhaus Koblenz, Koblenz, Germany
  • Hans-Christoph Pape - Universitätsspital Zürich, Klinik für Traumatologie, Zürich, Switzerland
  • Dan Bieler - Bundeswehrzentralkrankenhaus Koblenz, Klinik für Unfallchirurgie und Orthopädie, Wiederherstellungs- und Handchirurgie, Verbrennungsmedizin, Koblenz, Germany

Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2022). Berlin, 25.-28.10.2022. Düsseldorf: German Medical Science GMS Publishing House; 2022. DocAB28-191

doi: 10.3205/22dkou159, urn:nbn:de:0183-22dkou1599

Published: October 25, 2022

© 2022 Scherer et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objectives: Unlike many other types of weapons, firearms are of special interest due to their high lethality and criminal value. There is lacking data on the epidemiology of gunshot wounds in Central Europe in a clinical context and especially the clinical (resuscitation) management as well as the outcome of victims with sustained firearm injuries. Thus, the aim of this study was to review the current legal frameworks on firearms in Germany, Austria and Switzerland and secondly to retrospectively analyze the epidemiology of gunshot wounds, prehospital and clinical management as well as the outcome.

Methods: All patients with sustained gunshot injury in the period from 1st January 2009 to 31st December 2019 who were transferred to a level 1 or 2 trauma center in Germany, Switzerland and Austria were analyzed retrospectively regarding trauma mechanism, injury severity, injured body region and mortality, using data from the TraumaRegister DGU® (TR-DGU).

Results and conclusion: In total, there were 111 gunshot victims in Austria (A), 102 in Switzerland (S) and 1099 in Germany (G) during the respected time period. The mean injury severity score (ISS) was 25 (A), 31.5 (S) and 23.4 (G). Almost 60% of all patients with gunshot wounds died in Austria, 52% in Switzerland and 42% in Germany. Overall, more than 50% of the gunshot injuries were due to suspected violent crime in the age group of 0 to 40 years. The incidence of suspected suicide increased rapidly from the age of 40 to up to 93.6% in patients aged above 80 years. Accidental gunshot wounds had a peak in patients aged < 20 years (27.3%) and showed a steady decline with advanced age. The highest mortality in accidental gunshot wounds was seen in Austria (25%) followed by Switzerland (14.3%) and Germany (11.2%), whereas death in suspected suicide occurred most often in Switzerland (82.1%), followed by Austria (75.3%) and Germany (63.7%). Most of the gunshots to the head were due to suspected suicide (83.4%), whereas gunshots to the body stem and the extremities were mainly due to suspected crime (51.3%-73.6%).

Overall, gunshot wounds are rare, but there is evidence that gun laws may have an impact on gunshot wounds with suicidal intent.