High Rates of Chronic Pain, PTSD in Firearm-Injury Survivors

By Anne Harding

January 28, 2020

NEW YORK (Reuters Health) - Firearm-injury survivors have a much higher burden of chronic pain and post-traumatic stress disorder (PTSD) and worse mental and physical quality of life than car-crash survivors with similar injuries, new findings show.

A year after being shot, 67.7% of survivors reported having pain every day, 53.2% had a positive screening test for PTSD, 38.7% had new functional limitations in their activities of daily living and 59.1% of those who had been employed at the time of their injury had not gone back to work, Dr. Juan Pablo Herrera-Escobar of Brigham and Women's Hospital in Boston and his colleagues found.

"The impact of firearm injuries is not limited to death," Dr. Herrera-Escobar told Reuters Health by phone. "There is a substantial, long-term burden that is borne in survivors, and this is huge, and it affects multiple domains such as mental health, physical health, reintroduction to society and quality of life."

In 2017, there were three survivors of firearm injuries for every firearm-related death, Dr. Herrera-Escobar and his team note in Annals of Surgery. Little is known about how survivors fare after being shot, they add, although injury survivors overall can be at increased risk of an array of mental, physical, and social health problems for years after the injury occurred.

Since 2015, Dr. Herrera-Escobar and colleagues at two other Level 1 trauma centers in Boston have collected outcome data on traumatic injury survivors in the Functional Outcomes and Recovery After Trauma Emergencies (FORTE) project.

In the new study, they used 2015-2018 data from FORTE to compared outcomes for 62 firearm-injury survivors and 255 survivors of motor vehicle crashes (MVC) matched for injury severity at six and 12 months after the injury occurred.

Compared to the crash survivors, the firearm injury survivors were at significantly increased risk of suffering daily pain (adjusted odds ratio, 2.3) and screening positive for PTSD (aOR, 3.06).

They also had significantly lower physical and mental health-related quality of life compared to both the general population and to the MVC survivors.

"There is a pressing need for targeted long-term follow-up care, physical rehabilitation, mental health screening, and interventions for survivors of firearm violence," the authors write. "This study informs the dialog for the firearm injury public health crisis in the United States in an area that has been previously neglected."

SOURCE: https://bit.ly/36t3RMt Annals of Surgery, online January 16, 2020.