## understanding and Improving care for Gunshot Injuries: A Dissertation by Karolina Nyberger
What is your dissertation about?
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Gunshot injuries are on the rise in Sweden,with deadly firearm violence more than doubling since 2011,setting the country apart from other European nations. This increase has significant medical, economic, and societal consequences, highlighting the critical role of healthcare in treating these injuries,” says Karolina nyberger, PhD student at the Department of Molecular Medicine and Surgery.
“My dissertation, “Vascular trauma and Haemorrhage after firearm injuries,” analyzes gunshot injuries, with a specific focus on bleeding and vascular damage. The research utilizes primarily Swedish data, alongside international comparisons from mass shooting events, to contribute knowledge that can prevent deaths and improve future treatment of gunshot wounds.
What are the most important results?
The dissertation reveals key insights into injury patterns. Gunshot injuries predominantly affect young men in urban areas, but are increasingly occurring in smaller towns across Sweden.
The most frequently injured areas are the legs,followed by the arms and abdomen. Tragically, one in six patients dies within 30 days of a gunshot injury, with the majority of these deaths occurring within the first hour, often due to bleeding or traumatic brain injury.
A concerning trend is that more deaths are occurring *before* patients reach the hospital,indicating a rise in the lethality of these incidents.
Vascular damage is strongly linked to higher mortality rates, especially damage to vessels in the head, neck, and chest. Analysis of death timelines shows that chest vessel damage contributes to particularly rapid fatalities. In mass shootings, injuries to legs, arms, chest, and abdomen are common, but approximately a quarter of deaths are linked to bleeding from major central vessels, emphasizing the critical need for rapid and effective bleeding control to improve survival rates.
How can this knowledge be applied?
The findings of this dissertation can directly improve care for gunshot injuries by emphasizing the need for swift intervention, especially to control life-threatening bleeding. Reducing the time to definitive bleeding control is crucial for increasing a patient’s chances of survival.These results can also inform the advancement of future guidelines for the treatment of gunshot injuries.
What are your future goals?
This dissertation has sparked numerous new research ideas, particularly in the field of trauma management for gunshot injuries. I am also eager to expand my international network and expertise through a postdoctoral position abroad.
Furthermore, our collaboration with the Forensic Medicines Agency has opened the door to a larger study comparing those who die from gunshot wounds with those who survive, in greater detail. The ultimate goal is to identify the factors that determine survival – knowledge that can directly impact future rescue efforts and healthcare practices,” says Karolina Nyberger.
