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Citation
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Miller KR, Egger ME, Pike A, Burden J, Bozeman MC, Franklin GA, Nash NA, Smith JW, Harbrecht BG, Benns MV. J. Trauma Acute Care Surg. 2021; ePub(ePub): ePub. |
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Abstract
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BACKGROUND: Current data on the epidemiology of firearm injury in the United States are incomplete. Common sources include hospital, law enforcement, consumer, and public health databases, but each database has limitations that exclude injury subgroups. By integrating hospital (inpatient and outpatient) and law enforcement databases, we hypothesized that a more accurate depiction of the totality of firearm injury in our region could be achieved.
METHODS: We constructed a collaborative firearm injury database consisting of all patients admitted as inpatients to the regional Level 1 trauma hospital (inpatient registry), patients treated and released from the Emergency Department (ED), and subjects encountering local law enforcement as a result of firearm injury in Jefferson County, Kentucky. Injuries recorded from Jan 1, 2016 to Dec. 31 2020 were analyzed. Outcomes, demographics, and injury detection rates from individual databases were compared to those of the combined collaborative database and compared using chi-square testing across databases.
RESULTS: The Inpatient Registry (n = 1441) and ED database (n = 1109) were conbined resulting in 2550 incidents in the Hospital database. The law enforcement database consisted of 2665 patient incidents, with 2008 incidents in common with the hospital database and 657 unique incidents. The merged collaborative database consisted of 3207 incidents. In comparison to the collaborative database, the inpatient, total hospital (inpatient and ED) and law enforcement databases failed to include 55, 20, and 17 percent of all injuries respectively. The Hospital captured nearly 94% of survivors but less than 40% of non-survivors. Law enforcement captured 93% of non-survivors but missed 20% of survivors. Mortality (11-26%) and injury incidence were markedly different across the databases.
DISCUSSION: The utilization of trauma registry or law enforcement databases alone do not accurately reflect the epidemiology of firearm injury and may misrepresent areas in need of greater injury prevention efforts. LEVEL OF EVIDENCE: Level III, retrospective comparative.
Language: en |