Clinical trial NCT05224570: Epidemiology of Gunshot Wounds Injuries Admitted in ICU in France
Official title: Epidemiology of Gunshot Wounds Injuries Admitted in Intensive Care Unit in France: a Retrospective Multicenter Observational Study
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Gunshot Wound
Lead sponsor: Centre Hospitalier Universitaire de Nīmes
Sponsor class: OTHER
First posted: 2022-02-04
Enrollment: 120
Sex: ALL
Minimum age (years): 15
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: RETROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: All patients who were admitted for gunshot wound care in ICU between 1st of January 2015 and June 30th 2021 at Nîmes University Hospital, Marseille North University Hospital, Montpellier DAR_A University Hospital, Toulon Military Teaching Hospital.

Brief summary: In civilian practice, the incidence of firearm violence depends on the country. In high income countries, most cases are reported in the USA or South Africa. In these countries, gunshot wounds (GSW) represent 20% of death cases in trauma centers, more than motor vehicle collisions.

The mortality in civilian practice occurs during the first 24 hours following GSW, mainly due to hemorrhage and traumatic brain injury, though long term effects on physical and psychological outcomes have also been shown.

Some factors of mortality specific to GSW have been established: multiples wounds, homicide vs suicide attempt, impact zone, or firearm caliber.

Few specific guidelines have been published concerning civilian GSW management. These cases are mostly treated in standard guidelines, such as hemorrhagic shock or traumatic brain injury guidelines. As in other trauma mechanisms, the "platinum ten minutes and golden hour" concept is applicable.

In Europe, the incidence of civilian GSW is much lower and few European studies have been published recently. Penetrating injuries in Europe are less likely to be GSW, and are more often self-inflicted than in the USA. In addition, European studies are heterogeneous, due to the difference in populations, healthcare systems and GSW being grouped with stabbing wounds under the label "penetrating trauma".

However, there is a global concern in Europe regarding a potential rise of GSW, with higher severity score than conventional trauma patients and often necessitate ICU admission. Studies analyzing data from different European countries show significantly different ICU admission rates for overall GSW, ranging from 17% up to 30%.

Therefore, the investigators conducted a multicenter, retrospective study on four French University Hospitals aiming to describe the epidemiology (mortality and type of organ damage) and identify prognosis factors of civilian GSW admitted in ICU.


Eligibility criteria: Inclusion Criteria:

* Admission for gunshot wound care in ICU between 1st of January 2015 and June 30th 2021 at Nimes University Hospital, Marseille North University Hospital, Montpellier University Hospital, Toulon Military Teaching Hospital.
* Patient ≥ 15 years old

Exclusion Criteria:

* Patient \< 15 years old
* Patient who objected to the use of their data.

Primary outcomes:
measure: Mortality
timeFrame: day 28
Secondary outcomes:
measure: Age
timeFrame: Day 0
measure: Sex
timeFrame: Day 0
measure: Comorbidity
timeFrame: Day 0
measure: Type of gunshot
timeFrame: Day 0
measure: Bullet impact zone
timeFrame: Day 0
measure: Delay to reach hospital
timeFrame: Day 0
measure: biological parameters at ICU admission
timeFrame: Day 0
measure: antibiotics cure
timeFrame: Day 0
measure: Blood transfusion
timeFrame: Day 0 to day 30
measure: Type of surgery
timeFrame: Day 0 to day 30
measure: renal replacement therapy
timeFrame: Day 0 to day 30
measure: length of ICU stay
timeFrame: Day 0 to day 30
Other outcomes:
Locations:
city: Nimes
country: France
facility: CHU de NIMES
Study officials:
affiliation: CHU NIMES
name: Loic ROUGERIE
role: PRINCIPAL_INVESTIGATOR
affiliation: CHU NIMES
name: Laurent MULLER, Md, PhD
role: STUDY_DIRECTOR
References: