Firework-related genitourinary trauma: a single institution case series
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UROLOGY - ORIGINAL PAPER
Firework‑related genitourinary trauma: a single institution case series Rishi R. Sekar1 · Alice T. Chu1 · Monica S. Vavilala2 · Judith C. Hagedorn1 Received: 16 January 2020 / Accepted: 5 April 2020 © Springer Nature B.V. 2020
Abstract Purpose The clinical impact of firework-related genitourinary trauma remains unknown. In this study, we aim to characterize injury patterns, interventions, and clinical outcomes of firework-related genitourinary injuries and evaluate the relationship with certain firework types. Methods A retrospective case series was conducted for patients treated at a level I trauma center from 2005 to 2019 who experienced firework-related genitourinary trauma. Fifteen patients sustained firework-related genitourinary injuries. Injury patterns, operative interventions, clinical outcomes, as well as details of firework type were examined. Results Firework-related genitourinary injuries were identified in 15 trauma patients. Mean age was 29.7 years (± 14.3, standard deviation), all (100%) patients were male, and most (11; 73.3%) were Caucasian. Average length of stay (LOS) was 10.5 days, and 4 (26.7%) patients required ICU admission. Ten (66.7%) patients underwent 28 operative interventions (mean 1.9 per patient), 7 (46.7%) of whom underwent 15 urologic specific intervention (mean 1.0 per patient). No injuryrelated deaths occurred. Considering firework type, 10 (66.7%) patients had mortar or shell-related injuries, while 3 (20.0%) involved firecrackers, and 2 (13.3%) involved bottle rockets. All (100%) patients sustained injuries that occurred with the use of legally obtained fireworks and 11 (73.3%) were active users. Conclusions Firework-related genitourinary injuries occurred most frequently in young men, lead to polytrauma with the scrotum and penis being the most common urologic sites, had high operative rates, and were most commonly associated with legally obtained fireworks, specifically mortar and shell fireworks. Further investigation is needed to understand the long-term sequelae of these injuries. Keywords Firework · Explosive · Trauma · Genitourinary
Introduction
* Judith C. Hagedorn [email protected] Rishi R. Sekar [email protected] Alice T. Chu [email protected] Monica S. Vavilala [email protected] 1
Department of Urology, University of Washington School of Medicine, 1959 NE Pacific, Box 356510, Seattle, WA 98195, USA
Department of Anesthesiology, University of Washington School of Medicine, Seattle, WA, USA
2
Firework-related injuries are a known public health problem in the United States and around the world. The United States Consumer Product Safety Commission (USCPC) estimates that approximately 9100 firework-related injuries were treated at United States (US) emergency departments in 2018 alone with a prevalence of 2.8 injuries per 100,000 individuals, with no significant improvement since the late 1990s [1]. Although firework sales and the use are regulated at the federal level, enforcement and further restriction vary widely at the state and local
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