Incidence and Cause of Potentially Preventable Death after Civilian Public Mass Shooting in the US

Smith, Edward; Sarani, Babak; Shapiro, Geoff; Gondek, Stephen; Rivas, Lisbi; Ju, Tammy; Robinson, Bryce R. H.; Estroff, Jordan; Fudenberg, John; Amdur, Richard L.; Mitchell, Roger A.

doi:10.1016/j.jamcollsurg.2019.04.016

Cited by 28 publications

(41 citation statements)

References 20 publications

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“…Although several reports analyzing the wounds in fatal firearm injuries have been published using autopsy data from combat and CPMS victims, surprisingly no studies describe the injury patterns in pediatric patients. [5][6][7] Our data highlight several key differences between these groups versus civilian pediatric firearm injuries. First, the mortality rate of pediatric firearm victims in our study was 11% vs 40% in CPMS.…”

Section: Fatalitiesmentioning

confidence: 75%

“…First, the mortality rate of pediatric firearm victims in our study was 11% vs 40% in CPMS. 6 Unique from CPMS, pediatric firearm injuries occur in a heterogenous population with varied mechanisms, anatomic injury patterns, and case fatality rates. Simply put, there are major categorical differences between these unique pediatric cohorts (eg, the unintentionally injured toddler, the teenage suicide victim, and the urban assault victim are inherently different populations).…”

Section: Fatalitiesmentioning

confidence: 99%

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Pediatric firearm injuries: Anatomy of an epidemic

Swendiman

Hatchimonji

Allukian

et al. 2020

Surgery

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Pediatric firearm injuries: Anatomy of an epidemic Gun violence is the second the leading cause of mortality in pediatric trauma, with only motor vehicle collisions responsible for more pediatric deaths. 1e3 Despite increasing rates of vehicle miles traveled each year, increased safety efforts have substantially decreased deaths attributable to motor vehicle accidents. In contrast, the number of pediatric firearm injuries has continued to increase (Fig 1). 3,4 In 2019, firearms resulted in the deaths of more than 1,300 infants and children, alongside thousands more surviving with devastating and serious life-altering injuries. 1,2 These injuries continue to be a very worrisome public health issue because they are more fatal than any other injury presenting to trauma centers (Fig 2). Pediatric firearm deaths are tragedies that should certainly be preventable, although effective solutions remain elusive. Contributing to the failure to decrease firearmrelated mortality are fundamental gaps in existing information, which prevent an accurate description of this problem. Literature SearchResearch describing the pattern of firearm injury in the pediatric population is rare. Recently, there have been several adult studies examining injury patterns, using autopsy analyses from victims of combat scenarios or civilian, public mass shootings (CPMS). 5e8 Epidemiologic studies describing pediatric firearm injuries have also been published. 2,9,10 However, the variations in anatomic patterns of pediatric firearm injury, which are key to improving care and prevention, have yet to be described. Here we present selected data characterizing firearm injury in the pediatric US population during the past 7 years from which we hypothesize that the firearm injury and mortality risk differs among infants, adolescents, and adults. We offer several observations that may provide guidance for future research and action.The National Trauma Data Bank provides encounter-specific information from more than 900 trauma centers in the United States and includes both pediatric and adult patients. Throughout a 7-year time frame (2010e2016), we extracted data after approval by the institutional review board of the University of Pennsylvania (Philadelphia, PA) for all patients aged 0 to 19 years with firearm-related injuries. These data included the following 5 mechanisms of firearm injury: assaults, unintentional injuries, suicides, legal intervention (ie, firearm injury incurred from a law enforcement officer in the line of duty), and undetermined use, all classified by diagnosis codes of external injury (Internation Classification of Disease, Clinical Modification, 9th and 10th revisions). We then used the Abbreviated Injury Scale to identify body region and severity of injury. There were 36,581 encounters for pediatric firearm injuries in 7 years, including 4,017 deaths, corresponding to a case fatality rate of 11.0%. Assaults accounted for the majority of cases (n ¼ 29,036, 79.4%). Fewer encounters occurred in children 14 years of age (12.8%), an...

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Section: Fatalitiesmentioning

confidence: 75%

Section: Fatalitiesmentioning

confidence: 99%

Pediatric firearm injuries: Anatomy of an epidemic

Swendiman

Hatchimonji

Allukian

et al. 2020

Surgery

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“…Emerging civilian data8 show the causes of death in US active shooter events, which point to lung injury (without any major vascular compromise) as the most likely cause of potentially preventable death. More data are required to cover all mechanisms of attack, but skills to adequately manage pneumothorax and ventilatory failure may be required earlier than in the cold zone, where it is currently provided in the UK.…”

Section: Why Timing Is Crucialmentioning

confidence: 99%

How to stop the dying, as well as the killing, in a terrorist attack

Park

Langlois²,

Smith

et al. 2020

BMJ

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“…Anders verhält es sich bei bedrohlichen Einsatzlagen (Amok oder terroristische Bedrohung): Neben Fahrzeugen werden häufig Sprengsätze, Schuss-oder Stichwaffen zum Einsatz gegen eine möglichst große Anzahl an Personen gebracht [5]. Dies stellt die Einsatzkräfte vor gleich mehrere Herausforderungen: ▪ Es muss mit einem hohen Patientenaufkommen gerechnet werden [6,7]. ▪ Patienten weisen häufig multiple Verletzungen auf [8,9].…”

Section: Introductionunclassified

“…Merke Im Rahmen der Triage und Erstversorgung geht es primär um die Minimierung potenziell überlebbarer Todesfälle, was gerade bei penetrierenden Thoraxverletzungen durch die Verhinderung bzw. Entlastung eines Spannungspneumothorax erreicht werden kann [7,13].…”

Section: Introductionunclassified