Firearm injury patients face measurable risk of bacterial infections

Firearm injuries are a major public health concern in the United States, but relatively little research has examined the infectious complications that can occur after treatment. To better understand these risks, researchers analyzed data from 24,024 adults hospitalized with firearm injuries at 323 hospitals across the country between January 2019 and May 2021.

The study found that 1,236 patients-about 5 percent-developed a bacterial infection. Most cases occurred during the initial hospitalization, with only 1.3 percent occurring during the 90-day follow-up period. Researchers also found that patients who underwent surgeries involving the head, neck, spine, liver, or lower abdomen faced the highest risk of developing bacterial infections.

Dr. Baghdadi and his team believe this is the largest analysis to date of bacterial infection patterns among hospitalized firearm injury patients in the United States. They also found that antibiotic exposure among patients who did not develop infections was generally low, which is reassuring and reflects current clinical recommendations to limit preventive antibiotic use in many firearm injury cases for patients without a bacterial infection.

The researchers found that patients who required surgical procedures involving the head, neck, spine, or lower abdomen were especially vulnerable to infection. At the same time, the study found that bacterial infection was not independently linked to a higher risk of death among patients who survived at least one night in the hospital.

The authors note that the research relied on administrative hospital data and that complete follow-up information may not have been available for every patient. Nonetheless, the large national dataset provided an opportunity to evaluate infection risk across a broad and diverse patient population.

"Recovery from firearm injuries can be complicated. Although our study focused on mortality, infections can impact recovery in multiple ways, contributing to long-term pain and disability." Dr. Baghdadi said. "By identifying the patients most likely to develop these complications, we hope this work contributes to more informed clinical decision-making and ultimately better outcomes for patients."

Baghdadi hopes that by developing a definition to identify patients with bacterial infection after firearm injury using observational and administrative datasets and then demonstrating how to apply it, other researchers will use the approach to run studies targeting more specific clinical questions.

Source:

University of Maryland School of Medicine

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