Review highlights significant need for comprehensive care for gun violence survivors
This new review article published in JAMA sheds light on the urgent need for comprehensive long-term medical care for individuals treated for firearm injuries, which have become a prevalent issue in the United States due to escalating gun violence in recent years.
According to the Centers for Disease Control and Prevention, more than 48,000 individuals lost their lives to firearm injuries in 2022, with an additional 120,000 individuals surviving gunshot wounds. While emergency care for these injuries is well-established, the pathways for long-term recovery for survivors, particularly in outpatient settings, are lacking and inconsistently implemented.
The review, authored by professors of surgery at the University of Maryland School of Medicine (UMSOM), compiles the latest evidence on the physical, neurological, psychological, and social consequences of firearm injuries, excluding those to the brain and spinal cord.
One of the key findings highlighted in the review is the prevalence of chronic pain among survivors, with nearly 68% reporting daily pain months after the injury. The review recommends a multimodal pain management approach combining medication with physical and alternative therapies.
Additionally, the review points out that approximately 75% of survivors are discharged with bullet fragments still in their bodies, posing a risk for lead poisoning. Regular blood lead level testing is advised, and surgical removal of fragments near joints or vital structures should be considered when feasible.
The psychological impact of firearm injuries is also addressed in the review, with over 50% of survivors screening positive for PTSD within a year of the injury. Screening for this condition is recommended, and effective treatments include trauma-focused cognitive behavioral therapy and antidepressant medication.
Furthermore, the review explores the functional decline and social impact of firearm injuries, noting that a significant portion of survivors experience long-term functional limitations and struggle to return to work. Quality of life measures among these individuals are notably lower compared to other trauma populations.
The review also highlights the risk of reinjury, with nearly 10% of survivors experiencing a second firearm injury, particularly young Black men. Hospital-linked violence intervention programs have shown promise in reducing recidivism through comprehensive support services.
In conclusion, the authors stress the importance of comprehensive care for firearm injury survivors beyond acute care efforts. Dean Mark T. Gladwin of UMSOM emphasizes the staggering cost of gun violence to the nation, both in terms of lives lost and economic impact. The review serves as a call to action for the medical community to address the lasting effects of firearm injuries and provide holistic care for survivors.
