A Geospatial Analysis of Severe Firearm Injuries Compared to Other Injury Mechanisms: Event Characteristics, Location, Timing, and Outcomes. (15th April 2016)

• Record Type: Journal Article
• Authors: Newgard, Craig D.; Sanchez, Brittany J.; Bulger, Eileen M.; Brasel, Karen J.; Byers, Adam; Buick, Jason E.; Sheehan, Kellie L.; Guyette, Frank X.; King, Richard V.; Mena‐Munoz, Jorge; Minei, Joseph P.; Schmicker, Robert H.
• Editors: Alpern, Elizabeth
• Other Names: Kerby Jeffrey D. investigator.; Wang Henry E. investigator.; Gray Randal investigator.; Christenson Jim investigator.; Christenson Jim investigator.; Andrusiek Dug investigator.; van Heest Rardi investigator.; Goulding Jim investigator.; Balfour Nick investigator.; Rainier‐Pope Nick investigator.; Beeson Jeffery investigator.; Gamber Mark investigator.; Simonson Robert investigator.; Gandhi Ragesh investigator.; Witham Williams investigator.; Simonson Robert investigator.; Ramsay Michael investigator.; Fabian Timothy C. investigator.; Croce Martin A. investigator.; Magnotti Louis J. investigator.; Maish George O. investigator.; Schroeppel Thomas J. investigator.; Zarzaur Ben L. investigator.; Weinberg Jordan A. investigator.; Holley Joe investigator.; Ludwig Gary investigator.; Burnett Alan investigator.; Barnes Debra investigator.; Aufderheide Tom P. investigator.; Pirrallo Ronald G. investigator.; Colella Riccardo investigator.; Forster Rosemarie investigator.; Pukansky Lauryl investigator.; Sternig Kenneth investigator.; Chin Eugene investigator.; Krueger Kim investigator.; Szewczuga Del investigator.; Funk Rebecca investigator.; Jacobsen Gail investigator.; Spitzer Janis investigator.; Cohn Jon investigator.; Jankowski Mike investigator.; Whitaker Robert investigator.; Rohlfing Mark investigator.; Rosandish Tom investigator.; Remington Adam investigator.; Knitter Joe investigator.; Ugaste Robert investigator.; Saidler Timothy investigator.; Reminga Thomas investigator.; Shepherd Dennis investigator.; Holzhauer Peter investigator.; Rubin Jonathan investigator.; Skold Craig investigator.; Alvarez Orlando investigator.; Harkins Heidi investigator.; Barthell Edward investigator.; Haselow William investigator.; Yee Albert investigator.; Whitcomb John investigator.; Castro Eduardo E. investigator.; Motarjeme Steven investigator.; Coogan Paul investigator.; Rader Keith investigator.; Glaspy Jeff investigator.; Gerschke Gary investigator.; Croft Howie investigator.; Brin Mike investigator.; Wilson Cory investigator.; Johnson Anne investigator.; Kumprey William investigator.; Ateyyah Khalid A. investigator.; Gourlay David investigator.; Kaslow Olga investigator.; Stiell Ian investigator.; Vaillancourt Christian investigator.; Dreyer Jonathan investigator.; Munkley Douglas investigator.; Prpic Jason investigator.; Maloney Justin investigator.; Affleck Andrew investigator.; Bradford Paul investigator.; Trickett John investigator.; Sykes Nicole investigator.; Graham Elaine investigator.; Hedges Cathie investigator.; MacPhee Renee investigator.; Nolan Liana investigator.; McLeod Shelley investigator.; Luke Robert investigator.; Michaud Sylvie investigator.; Broughton Marcia investigator.; Klass Christine investigator.; Morassutti Peter investigator.; Callaway Clifton investigator.; Tisherman Samuel investigator.; Daya Mohamud investigator.; Wittwer Lynn investigator.; Jui Jonathan investigator.; Muhr Marc D. investigator.; Griffith John investigator.; Free Cliff investigator.; Warden Craig R. investigator.; Gorman Kyle investigator.; Beeler Tina investigator.; Conway William investigator.; Newton Cyndi investigator.; Geiger Chris investigator.; Colvin Justin investigator.; Hollingsworth Mike investigator.; Shertz Mike investigator.; Malone Scott investigator.; Keim Eric investigator.; Sahni Ritu investigator.; DeHart Steve investigator.; Freedman Skip investigator.; Moreno Raymond investigator.; Chin Jonathan investigator.; Snyder Sheri investigator.; Boyce Doug investigator.; Charleston Mark investigator.; Stevens Mark investigator.; Schult Eric investigator.; Sullivan Scott investigator.; Getsfrid Jay investigator.; Barnes Roxy investigator.; Schreiber Martin investigator.; Karmy‐Jones Riyad investigator.; Dean Gubler K. investigator.; Davis Daniel P. investigator.; Vilke Gary M. investigator.; Garcia Ester M. investigator.; Coimbra Raul investigator.; Sise Michael J. investigator.; Copass Michael investigator.; Rea Tom investigator.; Eisenberg Mickey investigator.; Morrison Laurie J. investigator.; Nathens Avery investigator.; Verbeek Richard investigator.; Cheskes Sheldon investigator.; Rizoli Sandro B. investigator.; Slutsky Arthur investigator.; Mokedanz Dave investigator.; Austin David investigator.; Moran Philip investigator.; Wright Garrie investigator.; Martin Murray investigator.; Sanderson Michael investigator.; MacDonald Russell investigator.; McConnell Susan investigator.; Jones Verena investigator.; Beckett Warren investigator.; Baker Andrew investigator.; Hutchinson Jamie investigator.; Choong Karen investigator.; Welsford Michelle investigator.; Sne Niv investigator.; Rizoli Sandro investigator.;
• Is Part Of: Academic emergency medicine. Volume 23:Number 5(2016)
• Page Start: 554
• Page End: 565
• Publication Date: 2016-04-15
• Subjects: Emergency medicine -- Periodicals; 616.02505
• DOI: 10.1111/acem.12930
• Languages: English
• ISSNs: 1069-6563

Abstract

Abstract: Objectives: Relatively little is known about the context and location of firearm injury events. Using a prospective cohort of trauma patients, we describe and compare severe firearm injury events to other violent and nonviolent injury mechanisms regarding incident location, proximity to home, time of day, spatial clustering, and outcomes. Methods: This was a secondary analysis of a prospective cohort of injured children and adults with hypotension or Glasgow Coma Scale score ≤ 8, injured by one of four primary injury mechanisms (firearm, stabbing, assault, and motor vehicle collision [MVC]) who were transported by emergency medical services to a Level I or II trauma center in 10 regions of the United States and Canada from January 1, 2010, through June 30, 2011. We used descriptive statistics and geospatial analyses to compare the injury groups, distance from home, outcomes, and spatial clustering. Results: There were 2, 079 persons available for analysis, including 506 (24.3%) firearm injuries, 297 (14.3%) stabbings, 339 (16.3%) assaults, and 950 (45.7%) MVCs. Firearm injuries resulted in the highest proportion of serious injuries (66.3%), early critical resources (75.3%), and in‐hospital mortality (53.5%). Injury events occurring within 1 mile of a patient's home included 53.9% of stabbings, 49.2% of firearm events, 41.3% of assaults, and 20.0% of MVCs; the non‐MVC events frequently occurred at home. While there was geospatial clustering, 94.4% of firearm events occurred outside of geographic clusters. Conclusions: Severe firearm events tend to occur within a patient's own neighborhood, often at home, and generally outside of geospatial clusters. Public health efforts should focus on the home in all types of neighborhoods to reduce firearm violence.