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PHILADELPHIA — Gunshot wounds cause most survivors lasting harm that goes beyond what bullets do to their bodies, according to a new Penn study.

The study, which looked at almost 200 adult survivors of gun violence in Philadelphia, found that nearly half screened positive for likely post traumatic stress disorder several years after they were shot, and many had higher rates of unemployment and drug or alcohol use than before they were injured.

“This study’s results suggest that the lasting effects of firearm injury reach far beyond mortality and economic burden,” the study states. “Survivors of (gunshot wounds) may have negative outcomes for years after injury. These findings suggest that early identification and initiation of long-term longitudinal care is paramount.”

The research findings were published Wednesday in JAMA Surgery.

The victims: The study looked at gunshot victims injured between January 2008 and December 2017. They were all treated at one of the University of Pennsylvania’s three trauma centers. Of the 183 individuals who participated in the study, all had been assaulted, as opposed to a self-inflicted or unintentional injury.

The vast majority of the victims were black males. The average age at the time of the injury was 27 and the average time between when they were shot and when they participated in the study was about six years. Before they were injured, 76% had been employed. About 31% said they used drugs or alcohol before getting shot.

When they took part in the study, nearly 49% screened positive for likely PTSD, even several years later, compared to a lifetime prevalence of a little less than 7% for the general population. Their combined drug and alcohol use as a group had increased by over 13%, and their employment rate had decreased over 14%. The researchers also found they were much more likely than others to have limits on their physical functions, even years after the initial injury.

The findings support previous research that found long-term psychological and physical impacts of assault by various methods, but the new Penn study zeroed in on firearm victims.

“To our knowledge, this is the largest study focusing only on gunshot wound patients,” said lead author Michael A. Vella, now an assistant professor of surgery with the University of Rochester School of Medicine and Dentistry.

Deaths most often are used to measure levels of gun violence, but the harm is far more widespread, Vella said. “There are also patients who survive whose lives are still devastated. To give them a voice, I think, is pretty profound,” he said.

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