Costs of care for low-energy extremity gunshot injuries are reduced with standardized treatment

Mai P. Nguyen, Jonathan C. Savakus, Michael S. Reich, Joseph F. Golob, Amy A. McDonald, John J. Como, Heather A. Vallier

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Objectives: (1) To determine the overall treatment costs associated with isolated low-energy gunshot wounds (GSWs) to the extremity and (2) to estimate cost savings associated with a single-dose IV antibiotic strategy administered in the emergency room for patients with simple GSWs. Design: Retrospective review. Setting: Level I trauma center. Patients/Participants: Patients (N = 380) with extremity-only GSW injuries from 2010 to 2015 were retrospectively reviewed. Treatment was recorded including type and duration of antibiotics, admission, and surgical intervention. Main Outcome Measures: Costs were calculated including facility services in the operating room and hospital. Results: There were 460 GSWs in 380 patients with a mean age of 30 years old. There were 309 admissions, 273 operations performed, and 1010 days of antibiotics prescribed. The total inpatient facility cost to treat all patients was $1,701,154. Among 179 patients who could be treated by the single-dose antibiotic care pathway for simple GSWs, 132 patients (73%) received additional treatment with 108 hospital admissions, 26 debridement surgeries, and 322 days of additional oral and/or IV antibiotics. The single-dose antibiotic care pathway would have saved an average of $1436 per patient with simple GSWs in actual facility expenses. Conclusions: The overall cost associated with isolated low-energy GSWs to the extremity is high. Limiting antibiotics to a single IV dose in the emergency room can reduce treatment expenses substantially for patients with simple GSWs.

Original languageEnglish (US)
Pages (from-to)E61-E63
JournalJournal of orthopaedic trauma
Issue number2
StatePublished - Feb 1 2021

Bibliographical note

Funding Information:
This project was funded by a research grant from AO North America.

Publisher Copyright:
© 2020 Wolters Kluwer Health, Inc.


  • Cost
  • Fracture
  • GSW
  • Gunshot
  • Infection
  • Protocol
  • Saving

PubMed: MeSH publication types

  • Journal Article


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