{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:10:51Z","timestamp":1787008251299,"version":"build-2736575974"},"reference-count":27,"publisher":"SAGE Publications","issue":"9-10","license":[{"start":{"date-parts":[[2024,5,1]],"date-time":"2024-05-01T00:00:00Z","timestamp":1714521600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neurotrauma"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:p>\n                    Firearm injuries in the U.S. pose a significant public health burden, but data on gunshot wounds (GSWs) specifically involving the spine are scarce. We examined epidemiological trends in GSWs to the spine and associated spinal cord injury (SCI) and mortality rates. This was a cross-sectional study of data from level I-III trauma centers in the U.S. participating in the American College of Surgeons National Trauma Data Bank (ACS NTDB) in 2015-2019. We identified adult and pediatric patients presenting with GSW and evaluated those with Abbreviated Injury Scale codes indicating spinal involvement and SCI. We assessed in-hospital mortality and GSW-related SCI. A total of 5,021,316 patients were enrolled in the ACS NTDB. Of the 107,233 patients (2.1% of total) presenting with GSW, 9023 (8.4%) patients had spine involvement. Overall rates of GSW and spinal GSW were similar across years. The most common cause of spinal GSW injury was assault (86.7%). The cervical spine was involved in 24.2% of patients, thoracic spine in 42.8%, and lumbar spine in 39.7%. Cervical SCI was present in 8.7% of all spinal GSW (35.7% of cervical GSW), thoracic SCI in 17.4% (40.6% of thoracic GSW), and lumbar SCI in 8.1% (20.3% of lumbar GSW). The mean patient age was 29.0\u2009\u00b1\u200912.2 years, 88.5% were male, 62.4% were black, 23.7% were white, and 13.9% were another race. Blood alcohol content was \u22650.08 in 12.1%, and illicit drugs were positive in 24.4%. In-hospital mortality was high in patients with spinal GSWs (8.1%), and mortality was significantly higher with cervical involvement (18.1%), cervical SCI (30.7%), or thoracic incomplete SCI (13.6%) on univariate analysis. On multi-variate analysis of age (excluding patients &lt;16 years of age), sex, Injury Severity Score (ISS), complete SCI, and spinal area of involvement, only greater patient age (age 40-65 years: adjusted odds ratio [aOR] 1.52, 95% confidence interval [CI] 1.09-2.11,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.014; age &gt;65 years: aOR 3.90, 95% CI 2.10-7.27,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.001) and higher ISS (ISS 9-15: aOR 6.65, 95% CI 2.38-18.54,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.001; ISS 16-24: aOR 18.13, 95% CI 6.65-49.44,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.001; ISS &gt;24: aOR 68.44, 95% CI 25.39-184.46,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.001) were independently associated with in-hospital mortality risk after spinal GSW. These results demonstrate that spinal GSW is not uncommon and that older patients with more severe systemic injuries have higher in-hospital mortality risk.\n                  <\/jats:p>","DOI":"10.1089\/neu.2023.0081","type":"journal-article","created":{"date-parts":[[2023,9,11]],"date-time":"2023-09-11T06:41:11Z","timestamp":1694414471000},"page":"1112-1121","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":12,"title":["Epidemiology of Gunshot-Related Spinal Injuries and Related Risk Factors for In-Hospital Mortality in the United States from 2015-2019: A National Trauma Data Bank Analysis"],"prefix":"10.1177","volume":"41","author":[{"given":"Brandon A.","family":"Sherrod","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University of Utah, Salt Lake City, Utah, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason B.","family":"Young","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Utah, Salt Lake City, Utah, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher G.","family":"Wilkerson","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Utah, Salt Lake City, Utah, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica F.","family":"Bisson","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Utah, Salt Lake City, Utah, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew T.","family":"Dailey","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Utah, Salt Lake City, Utah, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus D.","family":"Mazur","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Utah, Salt Lake City, Utah, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,5,25]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2020.6696"},{"key":"e_1_3_6_3_2","unstructured":"Centers for Disease Control and Prevention. Educational Fund to Stop Gun Violence and Coalition to Stop Gun Violence. 2021. https:\/\/efsgv.org\/wp-content\/uploads\/2019CDCdata.pdf [Last Accessed May1 2022]."},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2015.10.025"},{"key":"e_1_3_6_5_2","doi-asserted-by":"publisher","DOI":"10.7326\/M18-1530"},{"key":"e_1_3_6_6_2","doi-asserted-by":"publisher","DOI":"10.1038\/sc.2010.146"},{"key":"e_1_3_6_7_2","doi-asserted-by":"publisher","DOI":"10.1179\/1079026813Z.000000000136"},{"key":"e_1_3_6_8_2","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2014.3332"},{"key":"e_1_3_6_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/BSD.0000000000001308"},{"key":"e_1_3_6_10_2","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.13918"},{"key":"e_1_3_6_11_2","unstructured":"American College of Surgeons Committee on Trauma. Trauma Quality Programs (TQP) Participant Use File (PUF) User Manual Admission Year 2019 version 1.0. 2021. 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