Article Abstract

The ED length of stay in gunshot injuries: experience in a metropolitan medical center

Authors: Liong-Rung Liu, Chang-Chih Chen, Jiun-I Lai, Yu-Hui Chiu, Wen-Han Chang


Background: As laws prohibit gun possession, civilian gunshot wounds (GSW) are relatively rare in Taiwan. Our hospital, Mackay Memorial Hospital, located at Taipei City is surrounded by nightclubs and red-light districts. Due to this unique location, our hospital becomes the first-line trauma center managing gunshot victims in northern Taipei. As few research articles have been published regarding this unique situation, we aimed to analyze the characteristics and the emergency department (ED) length of stay (LOS) of GSW patients in our hospital.
Methods: A 6-year retrospective analysis of 27 patients treated for GSW injuries from January 2012 to December 2017 was performed. The patients’ records were reviewed for clinical presentations and the LOS in ED.
Results: We found males (96.3%) were injured by guns more often than females (3.7%) in all age groups. The most common injured site was in the extremities (55.6%). With regards to the ER LOS, the average time were 72.2±34.5 minutes for patients with triage I and 207.4±143.9 minutes for patients with triage II. The ED LOS of patients whose Injury Severity Score (ISS) were more than 15 was 59.9±25.6 minutes, and 179.4±119.8 minutes for patients whose ISS score were between 9 to 15, respectively. Among these 27 patients, 13 patients had emergency surgery and their average ED stay time was 131.9±31.2 minutes. Even more, the average ED stay time could be shortened to 88.8±32.3 minutes in the 5 patients with trauma team activation (TTA).
Conclusions: TTA in severe GSW patients indeed shortens the ED LOS and might improve the quality of patient care. This is the result of better trauma systems, including advances in care from emergency medical services and the acute care surgical management.