Analysis of firearm-related injuries in patients presenting to the Emergency Department of Trakya University Hospital from 2020–2024

Firearm injuries are an important public health issue all over the globe, which is also amplified due to their innate nature of both a need for urgent medical intervention and ensuing legal proceedings. Increasing individual gun ownership has inevitably caused a rising pattern of emergency department admissions. In this study, 202 cases of firearm injuries that were admitted to the Emergency Department of Trakya University Health Research Application Center have been retrospectively reviewed. The demographics of the cases, data about the moment of injury, the manner of the injury, the type of firearm used, the shooting distance, the localization of the injury, and the presence and severity of both internal organ damage and fractures were evaluated. Severity of the injuries was classified in accordance with the 86th, 87th, and 89th articles of the Turkish Penal Law. Findings were presented by descriptive statistics, and correlations between variables were tested by appropriate statistical methods. 90.1% of the cases were men, and 54% were in the 21–40 age group. It was shown that injuries had a similar distribution pattern by season, month, and hour. In 55% of the cases, blood alcohol concentration was not measured, and 55.4% were further referred to other departments by the ER. When the manner of injuries was examined, homicidal intent was the most common at 78.2%. In suicidal cases, fatal outcomes showed statistical significance. When the type of firearm was analyzed, handguns were first at 60.9%, followed by shotguns at 36.1%. When the firing distance was investigated, 74.8% of the cases were injured by long-range shootings, and in 5.4% of the cases, the range was indeterminate. In 49.5% of the cases, lower extremities were affected, which showed a statistically significant correlation with homicidal acts. Head and neck injuries were seen most commonly with shotgun injuries, which also showed statistical significance. Internal organ injuries occurred in 35.6% of the cases; the most commonly injured organs were determined to be the lungs and brain. In the sample, 47.5% of the cases had bone fracture/fractures, of which 70.8% were severe in nature. While the existence of a fracture was more common in handgun injuries, the extent of the injury was more severe in shotgun injuries. It was determined that 98% of the injuries were not of a minor nature that could be resolved with simple medical intervention, and in 93.2% of the cases, they did not involve the permanent impairment or loss of function of any of the person's senses or organs. In conclusion, firearm-related injuries should be evaluated accurately and comprehensively in both medical and forensic processes. Physicians should not rely solely on clinical examination but must document all findings, which will contribute to the effective conduct of the forensic proceedings. Furthermore, it is recommended that policies aimed at reducing individual firearm ownership be established, and public awareness campaigns be implemented. Keywords: Firearm injury, handgun, shotgun, manner of injury, firing distance