Use of ShotSpotter detection technology decreases prehospital time for patients sustaining gunshot wounds

Goldenberg, Anna; Rattigan, Deviney; Dalton, Michael K.; Gaughan, John; Thomson, J. Scott; Remick, Kyle N.; Butts, Christopher A.; Hazelton, Joshua P.

doi:10.1097/ta.0000000000002483

Cited by 27 publications

(15 citation statements)

References 23 publications

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“…This study demonstrated no significant difference in prehospital times, scene time, or transport duration for patients who sustained GSWs when acoustic detection occurred compared to patients who experienced GSW when no acoustic detection occurred. The previous reports did find a difference in prehospital time in those associated with acoustic detection showing improved transport times but are geographically distinct [12,13].…”

Section: Discussionmentioning

confidence: 80%

“…ADS use by police has been previously reported [2,[10][11][12][13]. ADS impact in gunshot survival may be less significant in smaller cities or those with sufficient trauma care resources, particularly in relation to the gun violence "hot spots" as demonstrated here [10][11][12][13]. While the utility of ADS coverage for an entire municipality may act as a deterrent to gunplay, the impact on healthcare remains mixed [10][11][12][13].…”

Section: Discussionmentioning

confidence: 99%

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Firearm Acoustic Detection in Hartford, Connecticut: Outcomes of a Trauma Center – Law Enforcement Collaboration

Gontarz¹,

Siddiqui²,

Campbell³

et al. 2021

Cureus

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IntroductionFirearm homicide is a leading cause of violence-related death in the United States. Unfortunately, more than 80% of illegal firearm discharges are never reported to police by traditional means. ShotSpotter TM (Newark, California) is an acoustic firearm event detection system that can localize gunfire, prompting police, and subsequent emergency medical services (EMS) presence. Previously reported healthcare effects of acoustic detection are speculative in nature. We sought to investigate Hartford, Connecticut's experience with ShotSpotter TM given its smaller size and broad coverage. MethodsThe three trauma centers in Hartford (two for adults and one for pediatric) collaborated with the Hartford Police to review outcomes of victims with acoustically detected gunshots and compare them to those who went undetected. We performed a retrospective review of patients who presented with gunshot wounds (GSW) over a 30-month period, from January 1, 2016 to June 30, 2018. Victim location and acoustic detection were reconciled by the police department and hospital staff independently. Patients were individually matched for location, prehospital response, treatment durations, and hospital outcomes. ResultsOf 387 GSW, 157 (40.6%) presented via EMS and were included in the sample. Of these, 89 correlated to a detection event (56.7%) and 68 had no correlating event (43.3%). These two groups had no difference in prehospital treatment times, scene and transport duration, and injury severity. Further, the need for surgery or transfusion, lengths of stay, and disposition, including mortality, did not differ. ConclusionsDespite limited previous reports demonstrating conferred benefits to acoustic detection of gunshots, Hartford's experience showed no benefit. The potential for such systems to act as early warning systems is evident but may depend on a city's resources, geography, and technology.

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Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Firearm Acoustic Detection in Hartford, Connecticut: Outcomes of a Trauma Center – Law Enforcement Collaboration

Gontarz¹,

Siddiqui²,

Campbell³

et al. 2021

Cureus

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“…Additionally, the lack of prehospital interventions by police 10,14 would logically result in shorter prehospital times. Several recent studies on the relationship between prehospital time and mortality have shown that not all patients benefit from shorter prehospital times.…”

Section: Discussionmentioning

confidence: 99%

“…This could include changes to policing that result in closer relationships with at-risk communities and trauma center educational outreach. Though somewhat controversial, the gunshot detection technology ShotSpotter has been used with considerable success in some cities 14,16 and has the potential to mitigate delays in the notification that a firearm assault has occurred. Finally, and perhaps most importantly, we believe our findings support the consideration of implementing police transport of gunshot victims in New Orleans.…”

Section: Discussionmentioning

confidence: 99%

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A Tale of Two Cities: What’s Driving the Firearm Mortality Difference in Two Large Urban Centers?

Friedman

Mytty

Ninokawa

et al. 2021

The American Surgeon

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Introduction Per police data, the case fatality rate (CFR) of firearm assault in New Orleans (NO) over the last several years ranged between 27% and 35%, compared with 18%-22% in Philadelphia. The reasons for this disparity are unknown, and potentially reflect important system differences with broader implications for the reduction of firearm mortality. Methods A retrospective analysis of police and city-specific trauma databases between 2012 and 2017 was performed. Victims of firearm assaults within city limits were included. Univariate analysis was performed using chi-square for categorical and t-test for continuous variables. Bivariate analysis was conducted using logistic regression. Results Per police data, the CFR of firearm assault was 31% in NO and 20% in Philadelphia. However, per trauma registry data, the CFR of firearm assault was 14% in NO and 25% in Philadelphia. Patients in Philadelphia were older, had higher injury severity score, and lower blood pressure. Patients in NO had higher rates of head injury. 51% of patients in Philadelphia arrived via police compared to <1% in NO. There was no mortality difference between police and emergency medical service (EMS) transport. Longer EMS prehospital times were associated with increased mortality in NO but not Philadelphia. A much larger percentage of patients died on-scene in NO than Philadelphia. Conclusions Our findings suggest that the major driver of increased mortality following firearm assault in NO compared with Philadelphia is death prior to the arrival of first responders. Interventions that shorten prehospital time will likely have the greatest impact on mortality in NO. This should include the consideration of police transport.

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Association Between Geospatial Access to Care and Firearm Injury Mortality in Philadelphia

et al. 2022

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ImportanceThe burden of firearm violence in US cities continues to rise. The role of access to trauma center care as a trauma system measure with implications for firearm injury mortality has not been comprehensively evaluated.ObjectiveTo evaluate the association between geospatial access to care and firearm injury mortality in an urban trauma system.Design, Setting, and ParticipantsRetrospective cohort study of all people 15 years and older shot due to interpersonal violence in Philadelphia, Pennsylvania, between January 1, 2015, and August 9, 2021.ExposuresGeospatial access to care, defined as the predicted ground transport time to the nearest trauma center for each person shot, derived by geospatial network analysis.Main Outcomes and MeasuresRisk-adjusted mortality estimated using hierarchical logistic regression. The population attributable fraction was used to estimate the proportion of fatalities attributable to disparities in geospatial access to care.ResultsDuring the study period, 10 105 people (910 [9%] female and 9195 [91%] male; median [IQR] age, 26 [21-28] years; 8441 [84%] Black, 1596 [16%] White, and 68 other [&lt;1%], including Asian and unknown, consolidated owing to small numbers) were shot due to interpersonal violence in Philadelphia. Of these, 1999 (20%) died. The median (IQR) predicted transport time was 5.6 (3.8-7.2) minutes. After risk adjustment, each additional minute of predicted ground transport time was associated with an increase in odds of mortality (odds ratio [OR], 1.03 per minute; 95% CI, 1.01-1.05). Calculation of the population attributable fraction using mortality rate ratios for incremental 1-minute increases in predicted ground transport time estimated that 23% of shooting fatalities could be attributed to differences in access to care, equivalent to 455 deaths over the study period.Conclusions and RelevanceThese findings indicate that geospatial access to care may be an important trauma system measure, improvements to which may result in reduced deaths from gun violence in US cities.

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Use of ShotSpotter detection technology decreases prehospital time for patients sustaining gunshot wounds

Cited by 27 publications

References 23 publications

Firearm Acoustic Detection in Hartford, Connecticut: Outcomes of a Trauma Center – Law Enforcement Collaboration

Firearm Acoustic Detection in Hartford, Connecticut: Outcomes of a Trauma Center – Law Enforcement Collaboration

A Tale of Two Cities: What’s Driving the Firearm Mortality Difference in Two Large Urban Centers?

Association Between Geospatial Access to Care and Firearm Injury Mortality in Philadelphia

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