Does the Declining Lethality of Gunshot Injuries Mask a Rising Epidemic of Gun Violence in the United States?

Abstract

Recent mass shootings in the U.S. have reignited the important public health debate concerning measures to decrease the epidemic of gun violence. Editorialists and gun lobbyists have criticized the recent focus on gun violence, arguing that gun-related homicide rates have been stable in the last decade. While true, data from the U.S. Centers for Disease Control and Prevention also demonstrate that although gun-related homicide rates were stable between 2002 and 2011, rates of violent gunshot injuries increased. These seemingly paradoxical trends may reflect the declining lethality of gunshot injuries brought about by surgical advances in the care of the patient with penetrating trauma. Focusing on gun-related homicide rates as a summary statistic of gun violence, rather than total violent gunshot injuries, can therefore misrepresent the rising epidemic of gun violence in the U.S.

Long-term mortality of patients surviving firearm violence

“…Second, some patients may have extremely high use, as evidenced by the upper range of usage. As civilian mortality rates from penetrating injuries have fallen due to advances in trauma care, more patients are living with long-term sequelae of firearm violence 25. In these patients, the intensity and frequency of care may be especially great.…”

Safety of Neural Stem Cell Therapy for Traumatic Brain Injury

“…Despite increasing incidence, timely neurosurgical intervention aided with improved neuroimaging and advances in acute trauma management have lowered the firearm fatality rate {Joseph, 2014 #42;Lin, 2012 #164;Young, 2008 #56}. Thus, among the estimated 5.3 million people living in the US with traumatic brain injury (TBI)-related disability, the proportion of gun-shot wound survivors has been rising steadily [3][4][5][6][7][8]. Among head injuries, penetrating injuries (PTBI) are associated with the worst outcomes [9,10], and no effective restorative treatment beyond physical therapy is currently available to mitigate post-TBI disability [9][10][11].…”

One Step at a Time, Stem Cell Therapy for Traumatic Brain Injury Needs Two More Breakthroughs

“…3 Despite increasing incidence, timely neurosurgical intervention aided with improved neuro imaging and advances in acute trauma management have lowered the firearm fatality rate. [4][5][6] Thus, among the estimated 5.3 million people living in the US with traumatic brain injury (TBI)-related disability, the proportion of gun-shot wound survivors has been rising steadily.…”

“…[4][5][6] Thus, among the estimated 5.3 million people living in the US with traumatic brain injury (TBI)-related disability, the proportion of gun-shot wound survivors has been rising steadily. 3,[7][8][9][10][11] Among head injuries, penetrating injuries (PTBI) are associated with the worst outcomes. 12,13 and no effective restorative treatment beyond physical therapy is currently available to mitigate post-TBI disability.…”