Breaking News
February 22, 2019 - Researchers create new map of the brain’s own immune system
February 22, 2019 - ICHE’s reviews on surgical infections, unnecessary urine tests, and nurses’ role in antibiotic stewardship
February 22, 2019 - UK Research and Innovation invests £200 million to create new generation of AI leaders
February 22, 2019 - Takeda collaboration to boost fight against Alzheimer’s and other neurodegenerative diseases
February 22, 2019 - Heavy drinking may change DNA, leading to increased craving for alcohol
February 22, 2019 - U.S. opioid deaths jump fourfold in 20 years; epidemic shifts to Eastern states | News Center
February 22, 2019 - 5 Questions with William Turner on Diversity in Medicine
February 22, 2019 - HHS Finalizes Rule Seeking To Expel Planned Parenthood From Family Planning Program
February 22, 2019 - Researchers uncover biochemical pathway that may help identify drugs to treat Alzheimer’s
February 22, 2019 - Biologist uses new grant to find ways to eliminate schistosomiasis
February 22, 2019 - Bag-mask ventilation to help patients breathe during intubation prevents complications
February 22, 2019 - AbbVie Announces New Drug Application Accepted for Priority Review by FDA for Upadacitinib for Treatment of Moderate to Severe Rheumatoid Arthritis
February 22, 2019 - Nature versus nurture and addiction
February 22, 2019 - New website connects researchers with data experts, resources | News Center
February 22, 2019 - Today’s Concerns About Drug Prices Echo The Past
February 22, 2019 - CT and Doppler equipment have low accuracy in detecting cerebral vasospasm and ischemia
February 22, 2019 - Study finds out similarity in function between healthy retina cell and tumor cell
February 22, 2019 - CWRU awarded NIH grant to identify effective treatments for intimate partner violence
February 22, 2019 - Oncotype DX Not Cost-Effective for Low-Risk Breast Cancer
February 22, 2019 - Scientists discover new type of immune cells that are essential for forming heart valves
February 22, 2019 - Talk About Déjà Vu: Senators Set To Re-Enact Drug Price Hearing Of 60 Years Ago
February 22, 2019 - Genetic defect linked to pediatric liver disease identified
February 22, 2019 - New cellular atlas could provide a deeper insight into blinding diseases
February 22, 2019 - Growing number of cancer survivors, fewer providers point to challenge in meeting care needs
February 22, 2019 - Innovative compound offers a new therapeutic approach to treat multiple sclerosis
February 22, 2019 - $1.5 million grant to develop opioid treatment program for jail detainees
February 22, 2019 - FDA’s new proposed rule would update regulatory requirements for sunscreen products in the U.S
February 22, 2019 - Most Hip, Knee Replacements Last Decades, Study Finds
February 22, 2019 - Wellness problems prevalent among ob-gyn residents
February 22, 2019 - In the Spotlight: “The world is your oyster in geriatrics”
February 22, 2019 - Successful testing of multi-organ “human-on-a-chip” could replace animals as test subjects
February 22, 2019 - Analysis of cervical precancer shows decline in two strains of HPV
February 22, 2019 - Sugary stent eases suturing of blood vessels
February 22, 2019 - From surgery to psychiatry: A medical student reevaluates his motivations
February 22, 2019 - Is New App From Feds Your Answer To Navigating Medicare Coverage? Yes And No
February 22, 2019 - New pacemakers powered by heartbeats could reduce need for surgery
February 22, 2019 - The United States records highest drug overdose death rates
February 22, 2019 - Phase 1 data reinforce safety profile of new drug for treating Duchenne muscular dystrophy
February 22, 2019 - Vitamin D supplementation less effective in the presence of obesity, shows study
February 22, 2019 - Novostia raises CHF 6.5 million to advance its aortic, mitral heart valve to clinical trials
February 22, 2019 - CPRIT awards nearly $20 million to The University of Texas MD Anderson Cancer Center
February 22, 2019 - Sarepta Announces FDA Acceptance of Golodirsen (SRP-4053) New Drug Application for Patients with Duchenne Muscular Dystrophy Amenable to Skipping Exon 53
February 22, 2019 - An institutional effort to reduce the amount of opioids prescribed following lumbar surgery
February 22, 2019 - Family-history-based models perform better than non-family-history based models
February 22, 2019 - Failure to take statins leads to higher mortality rates | News Center
February 22, 2019 - New study explains why some patients report phantom sensations after limb amputation
February 22, 2019 - First motor-controlled heart valves implanted by Mainz University Medical Center
February 22, 2019 - Novel preclinical model mimics persistent interneuron loss seen in preterm infants
February 22, 2019 - Global health burden of glaucoma has increased, study reveals
February 22, 2019 - A holistic approach key to minimize treatment complexity in patients with interstitial lung disease
February 22, 2019 - 1 in 10 middle-aged Chinese adults are at high risk for heart disease, finds study
February 22, 2019 - More than half a million breast cancer patient’s lives saved by improvements in treatment
February 22, 2019 - Study finds no evidence that tougher policies prevent teenage cannabis use
February 22, 2019 - New blood test detects genetic disorders in fetuses
February 22, 2019 - Lower Self-Perception Observed in Children With Amblyopia
February 22, 2019 - Up to 15 percent of children have sleep apnea, yet 90 percent go undiagnosed
February 22, 2019 - Rare pulmonary defect prompts parents’ nationwide search for answers | News Center
February 22, 2019 - Lesbian and bisexual women at greater risk of being overweight, study finds
February 22, 2019 - UQ research may explain why vitamin D is essential for brain health
February 22, 2019 - Heart Attacks Rising Among Younger Women
February 22, 2019 - How your smartphone is affecting your relationship
February 22, 2019 - Orthopaedic surgeon receives prestigious award, $10 million grant | News Center
February 22, 2019 - New sepsis test could save thousands of lives
February 22, 2019 - Cervical cancer could be eradicated by 2100
February 21, 2019 - Sustained smoking cessation can lower risk of seropositive RA
February 21, 2019 - Thousands with chronic UTIs are not receiving the treatment they need
February 21, 2019 - Are teens getting high on social media? The surprising study seeking the pot-Instagram link
February 21, 2019 - Stanford expands biobank services | News Center
February 21, 2019 - Scientists identify link between drinking contexts and early onset intoxication among adolescents
February 21, 2019 - Strong social support may reduce cardiovascular disease risk in postmenopausal women
February 21, 2019 - Rapid expansion of interventions could prevent up to 13 million cases of cervical cancer within 50 years
February 21, 2019 - Motif Bio Receives Complete Response Letter From The FDA
February 21, 2019 - Researchers map previously unknown disease in children
February 21, 2019 - A skeptical look at popular diets: Going gluten-free
February 21, 2019 - Podcast: KHN’s ‘What The Health?’ How Safe Are Your Supplements?
February 21, 2019 - Factors associated with increased risk of developing surgical site infections
February 21, 2019 - Anticipatory signals in eye movements can help measure attentive capacity, learning with greater precision
February 21, 2019 - Study explores daily exposure to indoor air pollutants
February 21, 2019 - Evening exercise does not negatively affect sleep, may also reduce hunger
February 21, 2019 - Artificial intelligence technique can be used to identify alcohol misuse in trauma setting
Gunshot victims require much more blood and are more likely to die than other trauma patients

Gunshot victims require much more blood and are more likely to die than other trauma patients

image_pdfDownload PDFimage_print
The Johns Hopkins Hospital blood bank is always ready to activate a mass transfusion protocol for patients who need large amounts of blood. Credit: Johns Hopkins Medicine

In a new analysis of data submitted to Maryland’s state trauma registry from 2005 to 2017, Johns Hopkins Medicine researchers found that gunshot victims are approximately five times more likely to require blood transfusions, they require 10 times more blood units and are 14 times more likely to die than people seriously injured by motor vehicles, non-gun assaults, falls or stabs.

A report of the findings of the study, designed to better understand demands for and shortages of blood transfusion products, was published Sept. 13 in Transfusion.

“Blood products cost a lot, come with a lot of risks for those transfused, and are scarce, so understanding what kinds of trauma are most likely to require more of them can help hospitals improve outcomes for trauma victims,” says Steven Frank, M.D., professor of anesthesiology and critical care medicine at The Johns Hopkins University and the study’s corresponding author.

To better understand the extent of blood use and associated costs for gunshot wound (GSW) victims, Frank and colleagues analyzed data from 23,422 Johns Hopkins Hospital trauma patients entered into the Maryland trauma registry from 2005 to 2017.

The average age for GSW patients was 27 and the average for non-GSW patients was 38. Males made up the majority of both types of patients—2,497 of 2,672 (93.45 percent) GSW patients and 13,954 of 20,750 (67.3 percent) of non-GSW patients were male.

Of all patients in the trauma registry, 2,672 (11.4 percent) had GSW injuries and 20,750 (88.6 percent) had non-GSW trauma injuries resulting from motor vehicle, nongun assaults, falls or stabs. GSW patients were five times more likely to require a blood transfusion (538 of 2,672, or 20.1 percent) compared to non-GSW patients (798 of 20,750, or 3.9 percent).

Credit: Johns Hopkins Medicine

When comparing all patients, the researchers found that GSW patients needed 10 times more units of blood than non-GSW patients (3.3 units versus 0.31 units for non-GSW patients).

Frank and colleagues also found that GSW patients were more likely to die in the emergency department (69 of 2,672, or 2.6 percent) than non-GSW patients (17 of 20,750, or 0.08 percent). Overall, GSW patients were about 14 times more likely to die (653 of 2,672, or 24.4 percent) than non-GSW patients (352 of 20,750, or 1.7 percent).

“The most likely explanation for these findings is the dramatic degree of injury severity in gunshot victims compared to all other types of trauma, including stab wounds,” says Frank.

In their analysis of cost for blood transfusions, the research team compared two types of costs: acquisition costs, or the cost of the unit itself ($200 per unit of red blood cells, $500 per unit of platelets, $50 per unit of plasma and $250 per dose of cryoprecipitate), and activity based costs, which are acquisition costs plus a fourfold increase for overhead that includes storage, viral testing, transport, compatibility testing and the cost of giving the blood to the patient.

Although overall, only 11.4 percent of all trauma patients had GSW injuries, more money was spent on blood for these patients than for all non-GSW trauma patients combined: $1,523,450 for GSW patients versus $1,140,250 for non-GSW patients in acquisition costs, and $6,093,800 versus $4,561,000 for non-GSW activity costs.

“For emergency preparedness purposes, hospitals that treat trauma need to have a sufficient amount of blood in the bank in order to treat patients coming in with gunshot wounds,” says Frank.

In the United States each year, over 116,000 people are injured and over 38,000 people die from gun-related injuries.


Explore further:
More americans DOA from gun, knife wounds

More information:
Vincent M. DeMario et al. Blood utilization and mortality in victims of gun violence, Transfusion (2018). DOI: 10.1111/trf.14925

Provided by:
Johns Hopkins University School of Medicine

Tagged with:

About author

Related Articles