Firearm injury research and epidemiology: A review of the data, their limitations, and how trauma centers can improve firearm injury research

Hink, Ashley; Bonne, Stephanie; Levy, Marc; Kuhls, Deborah A.; Allee, Lisa; Burke, Peter; Sakran, Joseph V.; Bulger, Eileen M.; Stewart, Ronald M.

doi:10.1097/ta.0000000000002330

Cited by 45 publications

(70 citation statements)

References 67 publications

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“…We identified 62 relevant publications 8 – 69 : 46 observational studies; seven interventional studies 18 , 38 , 55 , 60 , 64 , 66 , 67 ; one systematic review 15 ; and eight commentaries ( Figure 3A ). 22 , 23 , 33 , 46 , 56 , 62 , 65 , 69 Two-thirds of these publications were published between 2015–2020.…”

Section: Resultsmentioning

confidence: 99%

A Scoping Review of Current Social Emergency Medicine Research

Shah

Porta

Leung

et al. 2021

WestJEM

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Introduction: Social emergency medicine (EM) is an emerging field that examines the intersection of emergency care and social factors that influence health outcomes. We conducted a scoping review to explore the breadth and content of existing research pertaining to social EM to identify potential areas where future social EM research efforts should be directed. Methods: We conducted a comprehensive PubMed search using Medical Subject Heading terms and phrases pertaining to social EM topic areas (e.g., “homelessness,” “housing instability”) based on previously published expert consensus. For searches that yielded fewer than 100 total publications, we used the PubMed “similar publications” tool to expand the search and ensure no relevant publications were missed. Studies were independently abstracted by two investigators and classified as relevant if they were conducted in US or Canadian emergency departments (ED). We classified relevant publications by study design type (observational or interventional research, systematic review, or commentary), publication site, and year. Discrepancies in relevant publications or classification were reviewed by a third investigator. Results: Our search strategy yielded 1,571 publications, of which 590 (38%) were relevant to social EM; among relevant publications, 58 (10%) were interventional studies, 410 (69%) were observational studies, 26 (4%) were systematic reviews, and 96 (16%) were commentaries. The majority (68%) of studies were published between 2010–2020. Firearm research and lesbian, gay, bisexual, transgender, and queer (LGBTQ) health research in particular grew rapidly over the last five years. The human trafficking topic area had the highest percentage (21%) of interventional studies. A significant portion of publications -- as high as 42% in the firearm violence topic area – included observational data or interventions related to children or the pediatric ED. Areas with more search results often included many publications describing disparities known to predispose ED patients to adverse outcomes (e.g., socioeconomic or racial disparities), or the influence of social determinants on ED utilization. Conclusion: Social emergency medicine research has been growing over the past 10 years, although areas such as firearm violence and LGBTQ health have had more research activity than other topics. The field would benefit from a consensus-driven research agenda.

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Section: Resultsmentioning

confidence: 99%

A Scoping Review of Current Social Emergency Medicine Research

Shah

Porta

Leung

et al. 2021

WestJEM

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“…knives, battery, blunt objects. In contrast with the USA, in Europe, GSW are mostly considered a secondary concern [ 24 ]. Finland is one of the European countries with the highest firearm-related mortality; however, it was reported that almost half of GSW are unintentional, mostly related to diffusion of recreational hunting [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Epidemiology of trauma admissions in a level 1 trauma center in Northern Italy: a nine-year study

et al. 2021

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The aim of this study was to analyze the results of 9 years of trauma care and data collection in a level 1 urban trauma center in Northern Italy. Overall, 6065 patients have been included in the study; the number of patients managed yearly has doubled between 2011 and 2019. This rise mostly involved patients with injury severity score (ISS) < 16. Most injuries (94%) were blunt. Road traffic accidents, especially involving motorcycles, were the most common cause of injury. Self-inflicted injuries were responsible for less than 5% of trauma but they were severe in 56% of cases. The median age was 38 and it remained constant over the years; 43% of patients had 14–39 years of age. Different characteristics and patterns of injury were observed for each age group and gender. Males were more likely to be injured in the central years of life while females presented a trimodal pattern in the age distribution. Young adults (14–39 years old) were overall at higher risk of self-harm. Overall mortality was equal to 5.2%. Most deceased were male and ≥ 65 years of age.

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“…A retrospective study from January 2017 to December 2019 was performed using the National Trauma Database (NDTB) [3]. With more than 7.5 million electronic records, the NTDB is the world's largest trauma data repository [4] and the most robust source of clinical information for firearms injury [5]. All firearm related injuries were included, and weapon type was abstracted.…”

Section: Methodsmentioning

confidence: 99%

Suicide vs Homicide Firearm Injury Patterns, Weapons, and Mortality: A Study of the National Trauma Data Bank (NTDB)

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Doan

Vanier

et al. 2022

Preprint

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Background: Gun related mortality rate in the USA surpassed other developed countries. This study hypothesizes that injury patterns, weapon type, and mortality differ between suicide groups as opposed to homicide. Methods: The National Trauma Database (NDTB) was queried from January 2017 to December 2019. All firearm related injuries were included, and weapon type was abstracted. Differences between homicide and suicide groups by sex, age, race, and injury severity were compared using a Mann-Whitney test for numerical data and Fisher’s exact test for categorical data. The association between weapon type and mortality relative to suicide as opposed to homicide was assessed in Fisher’s exact tests. Significance was defined as p < 0.05. Results: There was 100,031 homicide and 11,714 suicide subjects met inclusion criteria. Homicides were mostly assault victims (97.6%), male (88%), black (62%), less severe injury (mean ISS 12.07) and median age 20 years old (IQR: 14, 30), (p < 0.01). Suicides were mostly male (83%), white (79%), more severe injury (mean ISS 20.73), and median age of 36 years old (IQR: 19, 54, p < 0.01). Suicide group had higher odds of head/neck (OR=13.6) or face (OR=5.7) injuries, with lower odds of injury to chest (OR=0.55), abdominal or pelvic contents (OR=0.25), extremities or pelvic girdle (OR=0.15), or external areas (OR=0.32). Mortality rate was higher for suicide group (44.8%; 95% confidence interval (CI): 43.9%, 45.7%) compared to the homicide group (11.5%; 95% CI: 11.3%, 11.7%). Conclusions: Suicide had higher mortality, more severe injuries, and more head/neck/facial injuries than homicide. Majority of suicides were with handguns. Level of Evidence: Level IV

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Firearm injury research and epidemiology: A review of the data, their limitations, and how trauma centers can improve firearm injury research

Cited by 45 publications

References 67 publications

A Scoping Review of Current Social Emergency Medicine Research

A Scoping Review of Current Social Emergency Medicine Research

Epidemiology of trauma admissions in a level 1 trauma center in Northern Italy: a nine-year study

Suicide vs Homicide Firearm Injury Patterns, Weapons, and Mortality: A Study of the National Trauma Data Bank (NTDB)

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