Study Suggests Chicago Is Under-Treating Gunshot Victims


Chicago just ended its deadliest year in nearly two decades.

The city saw 4,331 shooting victims last year, according to its police department. Now, a new study sheds light on the medical treatment that such victims receive in Cook County, Illinois, the second most populous county in the nation, which includes the city of Chicago.
Almost one-fifth of gun-related injuries countywide that met the criteria for treatment at a trauma center, from 2009 to 2013, were initially under-treated, according to the study, which was published in the journal JAMA Surgery on Wednesday.
In other words, those patients received initial treatment outside a trauma center. Nearly one-third of all patients with gun-related injuries in the study were treated in a non-trauma facility.
“I was not surprised by the number of cases treated in hospitals without trauma units. … What did surprise me was the number of firearm injuries,” said Lee Friedman, associate professor of environmental and occupational health sciences at the University of Illinois at Chicago, and a co-author of the study.
The study involved an analysis of nearly 10,000 gunshot injuries in a single county over five years, he said, adding, “We have become numb to firearm-related injuries.”
Other experts called the study important, but questioned whether it’s sufficient enough to draw conclusions about the possible under-treatment of gunshot victims.

Treating the wounded, without a trauma team

To assess whether a patient’s injury was serious enough to warrant treatment in a trauma center, of which there are 19 in Cook County, the researchers took a close look at the patients’ diagnosis codes in the data to learn more about the type of injury and the body region injured.
The criteria for a patient to be transported to a specialized trauma unit include the patient’s level of consciousness, vital signs and location of injury, for instance whether a gunshot wound is to the head, neck, torso or above the elbows or knees, according to guidelines from the Centers for Disease Control and Prevention.
“I would say the vital signs actually supersede the location in terms of importance for most trauma surgeons,” said Dr. Bryan Morse, assistant professor of surgery at Emory University School of Medicine and a trauma surgeon at Grady Memorial Hospital in Atlanta, who was not involved in the study.
The researchers found that some 28% of the patients were initially treated in non-trauma facilities.
Among those with injuries that met the criteria for treatment in a trauma center — which were 4,934 — the data showed that about 18% received initial treatment at a non-trauma facility, and about 10% of those were transferred to a trauma facility.
Morse said that he was surprised to see the number of patients that went to non-trauma centers, but added that the study had some major limitations.
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Jacqueline Howard

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