Today's News

Saturday, February 06, 1999

Gunshot wounds have great economic impact

The incidence and management of gunshot wounds to the upper extremities has a high impact on society, according co-author Raffy Mirzayan, MD, department of orthopaedic surgery, Los Angeles County, University of Southern California Medical Center, who reported his findings Saturday in poster exhibit 309. Dr. Mirzayan's study reviewed the cases of 100 patients with gunshot wounds to the upper extremities, who were treated at his institution.

"Complete records were available for 80 patients," said Dr. Mirzayan. "Hospitalization was for an average of 5.7 days (range: 1 to 30 days) and an average of 2.3 follow-up visits (range: 0 to 28) in clinics and occupational therapy. The total medical cost was $1,291,762 or an average of 16,961 per person. Many of the patients were transient, did not have Social Security numbers and 65 percent were lost to follow-up. The disabilities resulting from these injuries prevents patients to further contribute to society and forces them to rely on society to support them."

Dr. Mirzayan noted that the dominant extremity was involved in 36 percent of the cases. Injuries involved 64 hands, 18 wrists, five forearms, two elbows, two arms and one shoulder. Five patients had multiple injuries and three had bilateral injuries.

Follow-up at an average of 4.25 years after injury, included a questionnaire regarding marital status, level of schooling, pre- and post-injury employment status and income, disability status and several functional activities. A Social Security death index search was carried out and identified eight deceased patients. A search of the Los Angeles County sheriff's database revealed five incarcerated patients.

"Injuries resulted from gang activities, 36 percent; assaults, 29 percent; robberies, 13 percent; and self-inflicted wounds, 22 percent," said Dr. Mirzayan.

"Prior to the patients' injuries, 23 percent were married, 39 percent were single, 15 percent were divorced and 23 percent living with someone. After injury, 30 percent were married, 39 percent stayed single, 8 percent were divorced and 23 percent continued living with someone.

"Fifty-eight percent were working prior to injury; 25 percent were unemployed; and 16 percent were students. At time of our review, 69 percent were employed, however, patients returned to work at an average of 18 months after injury. Fifty-seven percent had to find a new job."

Co-authors of the study with Dr. Mirzayan, all from the department of orthopaedics, Los Angeles County, University of Southern California Medical Center, are Vahan Cepkinian, MD; Milan V. Stevanovic, MD, associate professor; and Stephen B. Schnall, MD, associate professor.

1999 Academy News Feb. 6 Index A
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Last modified 06/February/1999