News | Clinical Trials | November 30, 2019

Gunshot Injuries Have Long-term Medical Consequences

New research presented at RSNA19 focuses on identifying patterns and predict future outcomes for gun violence victims

Image by Kira Hoffmann from Pixabay  #RSNA19

Image by Kira Hoffmann from Pixabay 

November 30, 2019 — Researchers are trying to identify injury patterns and predict future outcomes for victims of gun violence who are seen in the emergency room and later readmitted to the hospital, according to research being presented next week at the annual meeting of the Radiological Society of North America (RSNA). They found that patients who had gunshot injuries to the chest or abdomen were more likely to be readmitted to the hospital.  

"Gun violence is a national health emergency and yet there is a profound lack of research on the long-term consequences of gunshot-related injuries," said lead researcher and radiology resident Corbin L. Pomeranz, M.D., from the Department of Radiology at the Sidney Kimmel Medical College at Thomas Jefferson University in Philadelphia, Pa. "As a level-one trauma center, we have an opportunity to study the outcomes for this patient population and to look for ways to provide better care to gunshot victims."

According to Pomeranz, the bulk of the cost of treating victims of gun violence is spent on ongoing care, including treating the complications associated with gunshot wounds.

"The vast majority of research on gun violence focuses on emergency care, but in reality only a tiny fraction of the billions spent on medical care from gun violence in the U.S is spent on direct expenses for emergency medical care," he said.

Pomeranz and a team of researchers performed a retrospective analysis of patients with a history of prior gunshot wounds who were seen in the emergency room at Thomas Jefferson University Hospital between January and April of 2018. During that time, 110 patients with a history of a gunshot injury returned to the hospital and underwent a total of 174 imaging exams. The majority of gunshot-wound patients in the study were men (91.8 percent), and the average age was 49.7 years.

"Radiology is pivotal in the treatment of these patients because every trauma patient will receive some type of imaging," he said. "Creating a regional patient database can provide a wealth of knowledge for improving both gun violence research and patient care."

Using the imaging database, the team collected information on the patients, including age, gender, admitting hospital unit, the number of readmissions and surgeries, imaging data and gunshot wound history.

Of the 110 patients, 36 patients with a history of gunshot wounds were readmitted to the hospital with neurologic, visceral (thorax [chest] plus abdomen) or extremity injuries. Of those, 18 were readmitted due to complications associated with their prior gunshot wounds.

Neurologic injuries were the most common injury in the study group (24 patients), followed by abdominal and chest wounds (9 patients). Three patients had major blood vessel injuries. Eighteen of the patients were readmitted to the hospital with complications associated with their initial gunshot wound injuries. Three surgeries were performed after readmission, two of which were chest surgeries.

A statistical analysis demonstrated that the type of gunshot injury was the strongest predictor of hospital readmission. Patients who had a gunshot wound to the thorax or abdomen were more likely to be readmitted to the hospital.

"Where you are shot has an effect on your long-term health," Pomeranz said.

Pomeranz said the preliminary study is small but warrants additional multi-hospital and regional studies of outcomes for gunshot patients. He hopes future studies collect additional information on gunshot victims, such as whether bullets or bullet fragments remain in the body, and treatment outcomes.

"The outcomes of gun violence can only be assessed once we have a firm understanding of injury patterns," he said. "A location and injury severity scale based on imaging findings could be used to predict long-term consequences as well as the costs of gunshot wounds."

The goal of the researchers is to show hospitals how they can build their own database to identify patients at risk for readmission. This information will tell the researchers which patients will need more aggressive home care, Pomeranz noted.

"We want to help these patients stay of out of the hospital, but we also want to help improve their quality of life," he said. "That's the physician's job."

For more information: www.rsna.org

Related Content

Detroit-based magnetic resonance imaging (MRI) technology company SpinTech, Inc. has acquired medical-imaging research and technology developer Magnetic Resonance Innovations, Inc. (MR Innovations).
News | Magnetic Resonance Imaging (MRI) | February 24, 2021
February 24, 2021 — Detroit-based magnetic resonance...
Findings indicate that PPC and GG are highly predictive of overall upstaging by PSMA PET/CT for patients with high-risk prostate cancer

Image courtesy of UCLA Health

News | PET-CT | February 23, 2021
February 23, 2021 — A...
Axial FLAIR MR image shows T2 prolongation in bilateral middle cerebellar peduncles (arrows). Findings were associated with restricted diffusion and areas of T1 hypointense signal without enhancement or abnormal susceptibility. Image courtesy of American Roentgen Ray Society (ARRS), American Journal of Roentgenology (AJR)

Axial FLAIR MR image shows T2 prolongation in bilateral middle cerebellar peduncles (arrows). Findings were associated with restricted diffusion and areas of T1 hypointense signal without enhancement or abnormal susceptibility. Image courtesy of American Roentgen Ray Society (ARRS), American Journal of Roentgenology (AJR)

News | Coronavirus (COVID-19) | February 22, 2021
February 22, 2021 — According to an...
Examples of the imaging performance of XPCI-CT (b,e) compared to conventional specimen radiography (a,d) and benchmarked against histopathology (c,f). he top row focuses on the similarity between the XPCI-CT slice in (b) and the histological slice in (c). Arrow 1 indicates margin involvement, arrow 2 a variation in density in the internal structure of the tumour mass, arrow 3 tumour-induced inflammation. All this is confirmed by the histological slice in (c), and hardly visible in the conventional image in

Examples of the imaging performance of XPCI-CT (b,e) compared to conventional specimen radiography (a,d) and benchmarked against histopathology (c,f). he top row focuses on the similarity between the XPCI-CT slice in (b) and the histological slice in (c). Arrow 1 indicates margin involvement, arrow 2 a variation in density in the internal structure of the tumour mass, arrow 3 tumour-induced inflammation. All this is confirmed by the histological slice in (c), and hardly visible in the conventional image in (a). The bottom row focuses on the detection of small calcifications, a key feature in DCIS. These are undetectable in (d), detected in (e), enhanced in the maximum intensity projection (MIP) image at the bottom of (f), and confirmed by histopathology in the top part of (f). The scale bar [shown in (b) and (e)] is the same for all images apart from (f), which has its own scale. Red arrows in (e) and (f) indicate the microcalcifications. Image courtesy of Professor Alessandro Olivo

News | Breast Imaging | February 22, 2021
February 22, 2021 — A new X-ray imaging scanne
F-18 FES PET images of patients with ER+/PR+/HER2- invasive ductal carcinoma. Left panel: Progressive disease seen at the 8-week time-point in a patient on sequential therapy. Right panel: Stable disease through all 3 time-points, remaining on study therapy for 6.7 months until disease progression on combined vorinostat aromatase inhibitor therapy. Image created by Lanell M Peterson, Research Scientist, University of Washington Medical Oncology, Seattle WA.

F-18 FES PET images of patients with ER+/PR+/HER2- invasive ductal carcinoma. Left panel: Progressive disease seen at the 8-week time-point in a patient on sequential therapy. Right panel: Stable disease through all 3 time-points, remaining on study therapy for 6.7 months until disease progression on combined vorinostat aromatase inhibitor therapy. Image created by Lanell M Peterson, Research Scientist, University of Washington Medical Oncology, Seattle WA.

News | Molecular Imaging | February 22, 2021
February 22, 2021 — Molecular imaging
Dr Sahar Saleem placing the mummy in the CT scanner

Dr. Sahar Saleem placing the mummy in the CT scanner. Image courtesy of Sahar Saleem

News | Computed Tomography (CT) | February 22, 2021
February 22, 2021 — Modern medical technology is helping scholars tell a more nuanced story about the fate of an anci
 Enterprise imaging systems provider Intelerad Medical Systems announced it has acquired Lumedx, a leading provider of healthcare analytics and cardiovascular information systems (CVIS). 
News | Enterprise Imaging | February 18, 2021
February 18, 2021 – Enterprise imaging systems provider Intelerad Medical Systems announced it has acquired...
GE Healthcare introduced its artificial intelligence (AI) automation features on its Voluson Swift ultrasound platform at the 2020 Radiological Society of North America (RSNA) virtual meeting. Features of this system include semi-automated contouring, auto identification of fetal anatomy and positioning on imaging. AI is seeing increasing integration in ultrasound systems from numerous vendors.

GE Healthcare introduced its artificial intelligence (AI) automation features on its Voluson Swift ultrasound platform at the 2020 Radiological Society of North America (RSNA) virtual meeting. Features of this system include semi-automated contouring, auto identification of fetal anatomy and positioning on imaging. AI is seeing increasing integration in ultrasound systems from numerous vendors.

Feature | Ultrasound Imaging | February 18, 2021 | By Dave Fornell, Editor
Recent advances in ultrasound image sy...
Example MR images from paediatric brain tumour patients. This first column shows T1-weighted images following the injection of gadolinium contrast agent. The second column shows T2-weighted images and the final column shows apparent diffusion coefficient maps calculated from diffusion-weighted images. (a–c) are taken from a patient with a Pilocytic Astrocytoma, (d–f) are from a patient with an Ependymoma and (g–i) were acquired from a patient with a Medulloblastoma.

Example MR images from paediatric brain tumour patients. This first column shows T1-weighted images following the injection of gadolinium contrast agent. The second column shows T2-weighted images and the final column shows apparent diffusion coefficient maps calculated from diffusion-weighted images. (ac) are taken from a patient with a Pilocytic Astrocytoma, (df) are from a patient with an Ependymoma and (gi) were acquired from a patient with a Medulloblastoma. Image courtesy of Nature Research Journal

News | Pediatric Imaging | February 17, 2021
February 17, 2021 — Diffusio...