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Abstract
Firearm related injuries are a major cause of morbidity and mortality in urban areas. The incidence of firearm injury is strongly related to race or ethnic group, sex and age. So the aim of this work was to study the fatal cases due to firearm injuries that came from Alexandria and Matrouh governorates over the period of sex months from January to June 2004 regarding age, sex, anatomical sites, nature of injury, time passed from injury to death and type of weapon used. In addition blood samples were taken for estimation of serum creatinine and uric acid.
The cases included in this study were divided into three groups:
Group (I): 7 cases of firearm cases from Matrouh.Group (II):5 cases of firearm cases from Alexandria. Group (III): 12 cases of normal deaths used as control. The results showed that the mean age of the studied cases was 31.42 ? 10.65 years. 83% of the cases were males and 17% were females. The nature of injury was homicide in 50% of cases, unintentional in 42% and suicide in 8%. 58% of cases were from Matrouh governorate and 42% were from Alexandria. 92% of cases had far firing and 8% had near fining. The site of injury was skull in 33% of cases, the abdomen in 33%, the chest in 17% and the back in 17%. 58% of cases died immediately after injury and 42% were hospitalized for variable periods. The cause of death was skull fracture and brain haemorrhage in 33% of cases, internal organs lacerations and haemorrhage in 33.5% and sepsis in 33.5%. Handgun was used in 84% of cases, shotgun in 8% and military rifle was used in 8% of cases. Relative relationship was found in 35.33% of cases. A statistically significant association was found between age and nature of injury, i.e. tendency for homicide in advanced age and unintentional shooting in younger age. Also a statistically significant association was found between the relativity of the assailant and the victim and the nature of injury. i.e., tendancy for unintentional shooting in relatives. A statistically significant association between the nature of injury and distance of firing, i.e. tendency for near or even contact firing in suicide. Also the anatomical site of injury was significantly associated with cause of death. i.e. skull injury lead to death due to brain haemorrhage while other sites of injury lead to death due to internal organs lacerations and haemorrhage and sepsis. As regard the results of serum creatinine and serum uric acid, their mean values were 1.87 mg/dl and 5.74 mg/dl respectively in firearm cases. These mean values were significantly higher than controls (0.39 mg/dl and 3.65 mg/dl respectively). Also we found that serum creatinine and serum uric acid were significantly associated with the time passed since injury to death i.e., the level of serum creatinine and serum uric acid increased as the time progressed. In conclusion serum creatinine and serum uric acid can be used as possible indicators of death due to firearm injury. Moreover their levels may be of help in prediction of the time passed from firearm injury till death.