71303 - Firearm mortality in Sweden 2012-2022: An analysis of injuries based on clinical data and autopsy findings

Introduction A nationwide study showed an annual increase of firearm related injuries and fatalities. The aim of this study was to characterize pre-and in-hospital deaths, lethal injuries and hospital interventions related to firearm injuries. Method All deaths between 2012 and 2022 was included and analyzed using autopsy records from The National Board of Forensic Medicine, patient records and the Swedish Trauma Registry. Self-inflicted injuries were excluded. Result Total number of deaths were 411 (57%, n=235 in-hospital). Median age was 25 yrs; men 92% (n =378); 73% 24-h mortality (n=172). The total number and prehospital deaths increased (both p<0.005) and a trend of decreased (p=0.003) in-hospital deaths between 2017-2022 (Fig 1). In all deaths, 49% (201/411) were combined injuries to head and trunk, 34% (140/411) only trunk and 17% (70/411) isolated injuries to head. Of in-hospital deaths, 76% (108/142) had injuries to trunk, 13% (19/142) in other areas, 9% (12/242) to head and 2% (3/142) combined injury to head and trunk. 258 surgical in-hospital procedures were registered in 135 patients and 59% (79/135) had more than one procedure. Thoracotomy (28% 73/258), exploratory laparotomy (13% 34/258) or craniotomy (3% 8/258) and 30.5% (n=25/82) combined laparotomy and thoracotomy. Discussion Deaths after firearm injuries increased during the study period and was caused by an increase in prehospital deaths. Combined injuries to the trunk and to the head were more common in prehospital compared to in-hospital deaths. The high number of surgical interventions demonstrates that lethal firearm injuries consume a lot of hospital resources.