Firearm-Related Traumatic Brain Injury: A Single-Center Experience near the US-Mexico Border

Introduction: Firearm-related traumatic brain injuries (FR-TBI) are complex with high mortality rates that require specialized care to treat. In this review, we seek to characterize FR-TBIs at a trauma center near the US-Mexico border.

Methods: This retrospective cohort study included all patients who were brought to the UC San Diego (UCSD) Health level 1 trauma center from 2018-2022 with a FR-TBI. Injuries occurring in both the US and Mexico were included in our analysis, with the latter being transferred to our center for advanced care. Patients were split into two groups based on their mechanism of injury - either assault or self-inflicted/undetermined (SI/U).

Results: 29 patients were included in our analysis; 18 in the assault cohort (32 years, 94% male) and 11 in the SI/U cohort (25 years, 91% male). A majority of patients in both cohorts were Hispanic (n = 14, 82% vs n = 6, 60%, p = 0.4). The assault cohort contained all ten (56%) Mexico patients, whereas only US patients were represented within the SI/U cohort (p = 0.003). Mortality was higher in the SI/U cohort (n = 10, 91%) compared to the assault cohort (n = 7, 39%). GCS, TBI type, and operative intervention were similar between cohorts. Hospital length of stay (LOS) and ICU LOS were also similar, though charges were higher in the assault cohort ($242,941 vs $94,814, p = 0.049).

Conclusion : Over the 5-year period at our trauma center near the US-Mexico border, the majority of patients with FR-TBIs were young Hispanic males. Over a third of all FR-TBI were transfers from Mexico, all of whom were injured due to assault. In contrast, self-inflicted FR-TBIs exclusively originated in the US and also exhibited higher mortality rates. This report highlights the unique severity of FR-TBIs and captures the gun violence epidemic in Mexico.