Characterizing Firearm-Related Traumatic Brain Injuries at a Trauma Center Near the United States-Mexico Border

Background: Firearm-related traumatic brain injuries (FR-TBIs) pose a public health crisis in the United States and Mexico. We sought to characterize FR-TBIs in a Level 1 trauma center near the United States-Mexico border. Methods: A retrospective cohort review was performed of patients who presented at a Level 1 trauma center near the U.S.-Mexico border from 2010 to 2023 and were diagnosed with FR-TBI. Patients were excluded if they were under eighteen years or did not have an acute traumatic brain injury diagnosis on admission. Demographic, clinical, and radiographic information including injury characteristics, surgical interventions, and clinical and hospital outcomes was collected. Statistical analyses were performed using StataMP version 18.0. Results: Eighty-four patients were identified (67 United States, 17 Mexico). Median age was 34 years, with 85.7% male patients and 44.0% Hispanic patients. Median Glasgow Coma Scale on admission was 3 (interquartile range [3.0, 9.3]). Traumatic brain injuries included intraparenchymal hemorrhage/contusion (n = 49), epidural hematoma (n = 9), subarachnoid hemorrhage (n = 52), and subdural hematoma (n = 48). Fourteen patients required intracranial pressure monitoring and 18 underwent neurosurgical operative interventions. Patients from Mexico had lower mortality rate (P = 0.015), longer hospital length of stay (P = 0.001), and higher median total hospital charges (P < 0.001). Conclusions: This study reveals disparities in hospital stay and hospital charges in patients from Mexico with FR-TBI compared to U.S. patients. Our findings underscore the growing burden of FR-TBIs on the Mexico on U.S. health care systems. Future research should further explore why these disparities exist and focus on prehospital factors.