Postoperative mortality following civilian firearms injury during war: A retrospective cohort study

Background: This study aims to identify factors affecting mortality following surgery for civilian firearms injuries using surgical classification as a surrogate marker of injury severity. Methods: This was a retrospective study of patients who underwent surgery at a tertiary university hospital in Turkey between 2011 and 2014. All patients had sustained firearms injury and had an American Society of Anesthesiologists score of I-II. A grading system defined by the Communiqué on Health Practices in Turkey was used based on the surgery type and anesthetic procedure to determine the severity of injury and its relation with patient outcome (survival or death). Results: The median duration of hospital stay of patients who were discharged post healing was significantly longer than those who died [12 (0–559).vs 7.5 (0–468) days, respectively]. Overall mortality was 11.3%; however, the mortality of patients was 8.1%, 40.3%, and 40.3% in groups A2, C, and D, respectively. Healing in groups A2, C, and D was 2.4%, 54.1% and 25.8%, respectively. Independent variables affecting the coefficient of patient discharge status for sex, age, and surgical groups A2, C, and D were found to be significant. Conclusion: There was an association between the surgical groups and the firearms injuries sustained by civilians. Moreover, the coefficients associated with surgical group in our model may help predict the mortality risk in similar populations