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Citation
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Manley NR, Croce MA, Fischer PE, Crowe DE, Goines JH, Sharpe JP, Fabian TC, Magnotti LJ. J. Am. Coll. Surg. 2019; 228(4): 427-434. |
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Abstract
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BACKGROUND: Data linking ballistics to injury is lacking. To address this data chasm, a partnership with law enforcement was developed to describe clinical outcomes from specific firearms.
METHODS: A random sample of patients with gunshot wounds over a 20-year period, ending 2015 was identified. Circumstances of incident, firearm type and/or caliber were extracted from police reports. Data on demographics, mortality, injury severity and clinical outcomes were collected from the trauma registry, and these datasets were linked. Firearms were stratified by velocity (high > 2500 ft/sec; low < 1200 ft/sec) and caliber (large =.40 and.45; small =.20 and.25) and compared over time.
RESULTS: Police reports were obtained on 366 patients who had a gun type or caliber documented. The majority were male (82%) with a median age of 28. 21% of patients had an Injury Severity Score >25, 60% required immediate operative intervention and overall mortality was 13%. The use of large caliber firearms increased from 4% (1996-2000) to 33% (2011-2015), whereas small caliber guns decreased from 33% to 7% over the same time period (p<0.0001). The use of high velocity firearm usage significantly increased (p=0.0320). Recovered shell casings doubled from the first decade to the second (2 vs. 4; p=0.0006). Both median New Injury Severity Score (p=0.0488) and hospital days (p=0.0321) increased from 1996-2015.
CONCLUSION: Larger caliber and higher velocity firearms have significantly increased over the past twenty years in conjunction with injury severity, hospital days and mean number of gun-related homicides per year (112 in 1996-2000 versus 143 in 2011-2015). Robust data sharing partnerships can be built between police and trauma centers to address the dearth of data on firearm crime and resulting injury.
Copyright © 2019. Published by Elsevier Inc.
Language: en |