Epidemiology, clinical patterns, and management outcomes of gunshot wounds in Somalia: a study from MSTH emergency department

Abstract Background Gunshot wounds (GSWs) constitute a significant cause of trauma-related morbidity and mortality in Somalia, particularly in conflict-affected regions. This study aimed to evaluate the epidemiology, clinical patterns, and management outcomes of GSWs presenting to the Emergency Department (ED) of Mogadishu Somali Turkish Hospital (MSTH). Methods A prospective descriptive study was conducted involving 150 patients with GSWs who presented to the MSTH ED. Demographic, clinical, radiology, and surgical data were collected and analyzed to determine injury patterns and outcomes. Results The majority of patients were male (86.7%), with a mean age of 28.9 ± 9.6 years. Most injuries occurred in individuals aged 20–29 years (82%). A significant proportion of patients were married (54.7%) and employed (59.3%). The most common victims were soldiers (30.0%) and passengers (18.7%). Injuries predominantly occurred during daytime (84.0%). Upon presentation, 72.7% were clinically stable, while 27.3% had unstable vital signs. The Kampala Trauma Score classified 41.3% of cases as moderate, 40.0% as mild, and 18.7% as severe. Anatomical sites most affected were the lower limbs (32.7%), chest (16.7%), and upper limbs (16.0%). Comminuted long bone fractures were observed in 18.0% of cases, and 8.0% sustained traumatic brain injuries. Surgical management was required in 67.3% of cases, with orthopedic surgery accounting for the highest proportion (40.0%). ICU admissions comprised 12.7%, and the overall ED mortality was 0.7%. A total of 63.3% were admitted to general wards, and 21.3% were discharged directly from the ED. Conclusion GSWs in Somalia predominantly affect young adult males and are frequently associated with extremity and thoracic injuries. Most patients present in a stable condition and require surgical management, primarily orthopedic procedures. Despite the severity of some injuries, the ED mortality rate was low. These findings underscore the need for targeted trauma care resources and preventive measures to mitigate firearm-related violence.