Treatment Outcome of Retained Bullet After Gunshot Wounds in a Resource-limited Setting: A Retrospective Study
Description
A retrospective study was conducted at Al-Nasar Hospital in Ibb, Yemen, on 103 patients with retained gunshot injuries who were brought to the emergency department between January 2004 and December 2020. The study followed the principles of the Helsinki Declaration, and Ibb University's ethics board authorized it (code number: IBBUNI.AC.YEM.2023.108). Before inclusion in this study, participants were informed about the research aims and provided signed consent. Principles treatments including patient stabilization, prophylactic antibiotics, laboratory, and radiologic investigations including radiographic x-ray, ultrasonography investigations, and computed tomography scans performed for all cases. Inclusion criteria: All patients diagnosed with retained bullet injuries in our emergency department were included in this study. Exclusion criteria: Patients presenting with pellet-gun, rubber-bullet, and self-inflicted injuries by firearms were excluded. Patients treated in other sentences or those who died before their hospital arrival were also excluded. Data collection: Demographic characteristics were (age, gender, residency), the main symptom description, time between injury and hospital arrival, the season of injury (i.e., usual time, marriage ceremonies and independence days, and wartime and political rallies), physical examination findings (type, locations), time to hospital arrival, the wound of entry and exit, treatment (surgery or conservative management), surgical procedures offered, surgical findings, need for blood transfusion, hospital stay, postoperative complications, and outcome. Outcome: The primary outcome was patient survival and postoperative complications occurrence, whereas the secondary outcome was to compare the number of patients affected according to injury seasons and mortality rates according to time to hospital arrival. Statistical analysis: The mean ± SD was used for numerical variables, and the frequency (percentage) was used for categorical variables. For numeric data, we used the Mann-Whitney U test, and for categorical data, we used the χ2 test in conjunction with Fisher's exact test. Differences were considered statistically significant when the p-value was less than 0.05. "SPSS (IBM SPSS, version 22, Armonk, New York: IBM Corp) was used to analyze the data."