Firearm-Related Traumatic Brain Injury Homicides in the United States, 2000-2019

Abstract

BACKGROUND: Traumatic brain injury (TBI) is a leading cause of homicide-related death in the United States. Penetrating TBI associated with firearms is a unique injury with an exceptionally high mortality rate that requires specialized neurocritical trauma care. OBJECTIVE: To report incidence patterns of firearm-related and nonfirearm-related TBI homicides in the United States between 2000 and 2019 by demographic characteristics to provide foundational data for prevention and treatment strategies. METHODS: Data were obtained from multiple cause of death records from the National Vital Statistics System using Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research database for the years 2000 to 2019. Number, age-adjusted rates, and percent of firearm and nonfirearm-related TBI homicides by demographic characteristics were calculated. Temporal trends were also evaluated. RESULTS: During the study period, there were 77 602 firearm-related TBI homicides. Firearms were involved in the majority (68%) of all TBI homicides. Overall, men, people living in metro areas, and non-Hispanic Black persons had higher rates of firearm-related TBI homicides. The rate of nonfirearm-related TBI homicides declined by 40%, whereas the rate of firearm-related TBI homicides only declined by 3% during the study period. There was a notable increase in the rate of firearm-related TBI homicides from 2012/2013 through 2019 for women (20%) and nonmetro residents (39%). CONCLUSION: Firearm-related violence is an important public health problem and is associated with the majority of TBI homicide deaths in the United States. The findings from this study may be used to inform prevention and guide further research to improve treatment strategies directed at reducing TBI homicides involving firearms.

Comparative Analysis of Clinical Severity and Outcomes in Penetrating Versus Blunt Traumatic Brain Injury Propensity Matched Cohorts

“…This is particularly striking given the considerable public health implications associated with PBI, mainly firearm-inflicted brain injuries. Almost half of all TBI-related deaths from recent years resulted from suicide and homicide, 2 , 3 with specific demographic groups, such as young men in metropolitan areas and non-Hispanic black individuals, bearing a disproportionately higher burden. Despite the dire epidemiological data, there is a significant deficit of good quality literature on PBI.…”

Letter: A Call to Action: A Neurosurgeon's Responsibility in Firearm Injury Prevention and Advocacy

“…8 Neurosurgeons are all too familiar with the complex management of these injuries, with primary injury to the brain tissue compounded by downstream effects of secondary injury, as well as possible associated cerebrovascular injuries, cerebrospinal fluid leakage problems, and other craniofacial or polytrauma issues. 9-12 Many patients suffer from debilitating neurological deficits even after neurosurgical intervention. 8,13…”

Penetrating Firearm-Inflicted Injury—The Neglected Traumatic Brain Injury

“…Almost one-half of all TBI-related deaths from 2016 to 2018 were attributable to suicide and homicide . Overall, young men living in metropolitan areas, and non-Hispanic Black persons had disproportionately higher rates.…”

“…There has also been a substantial increase from 2012 for women (associated with intimate partner violence). PBI has been reported to carry 60% to 90% mortality rate and accounts for approximately 20 000 civilian deaths per year in the US . For patients who arrive to a level I or II trauma center, estimates demonstrate a mean age of 36 years and mortality 55% …”

“…PBI has been reported to carry 60% to 90% mortality rate and accounts for approximately 20 000 civilian deaths per year in the US. 2,3 For patients who arrive to a level I or II trauma center, estimates demonstrate a mean age of 36 years and mortality 55%. 3 Guidelines and consensus-based efforts have been produced for the management of TBI, and their use has been associated with improved outcomes.…”