Fatality and Severity of Firearm Injuries in a Denver Trauma Center, 2000-2013

Sauaia, Angela; González, Eduardo; Moore, Hunter B.; Bol, Kirk A.; Moore, Ernest E.

doi:10.1001/jama.2016.5978

Cited by 35 publications

(37 citation statements)

References 6 publications

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“…Data from a level I trauma center in Denver, Colorado reported increasing firearm case-fatality compared to other trauma mechanisms from 2000–2013. 10 …”

Section: Discussionmentioning

confidence: 99%

“…9 Few studies have considered national trends in case-fatality for firearms in the context of other injury mechanisms. 10 Given a similar landscape of trauma care, juxtaposition of these trends can potentially unmask temporal changes that are not apparent when describing one injury mechanism in isolation. Furthermore, prior national investigations have not considered in-hospital and out-of-hospital deaths separately.…”

Section: Introductionmentioning

confidence: 99%

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Trends in Firearm Injury and Motor Vehicle Crash Case Fatality by Age Group, 2003-2013

et al. 2019

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Importance: If changes over time in trauma care apply to both firearm injuries and motor vehicle crashes (MVC) similarly, differences in mechanism-specific case-fatality trends may suggest changes over time in injury severity. Objective: We analyzed national trends in case-fatality percentages at level I and II trauma centers for injuries due to MVC, firearm assault, self-inflicted firearm injury, and unintentional firearm injury by age. We also analyzed trends in injury severity scores (ISS) and the percentage of out-of-hospital deaths by mechanism. Design/Setting/Participants: We conducted a repeated cross-sectional measures analysis from 2003–2013 using two data sources: 1) the National Trauma Data Bank National Sample Program with survey weights to estimate annual median ISS, total injured and total died at level I and II trauma centers, and 2) the Centers for Disease Control Wide-ranging Online Data for Epidemiologic Research for percentages of out-of-hospital deaths. Methods: We calculated annual case-fatality percentage (total died/total injured) by mechanism across three age groups: 1)15–34, 2) 35–54, and 3) ≥ 55, and five categories of ISS. We performed linear regression to estimate annual trends in case-fatality percentage by mechanism, age-group, and ISS. We estimated annual trends in percentages of out-of-hospital deaths and median ISS by mechanism. Sensitivity analyses included the Durbin-Watson statistic for autocorrelation and Prais-Winsten regression models. Results: Self-inflicted firearm injury and assault with a firearm had the two highest overall case-fatality percentages (42.8% and 11.1%, respectively). The injury case-fatality percentage was lower each year for MVC but did not change for any firearm intent overall, or for any age group. Overall, median ISS increased annually for firearm suicide (0.31 9%CI 0.00, 0.61). The annual percentage of out-of-hospital deaths was lower each year for MVCs (−0.24 95% CI −0.43, −0.05) but not for any firearm intents. In sensitivity analyses, the annual percentage of out-of-hospital deaths for MVC no longer showed a decline. Conclusions and Relevance: Stagnant case-fatality percentages for firearm injuries juxtaposed to improvements for MVCs across age-groups and ISS categories suggests worsening severity of firearm injuries over the study period.

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“…Data from a level I trauma center in Denver, Colorado reported increasing firearm case-fatality compared to other trauma mechanisms from 2000–2013. 10 …”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Trends in Firearm Injury and Motor Vehicle Crash Case Fatality by Age Group, 2003-2013

et al. 2019

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“…6,7,8 While speculative, recent studies suggest a continuing trend toward greater wound severity associated with the greater power of firearms in common use. 9,10 (Improved trauma care may have prevented an increase in the national case-fatality rate. 11 ) It is widely accepted among medical and public health professionals that the likelihood of death in an assault increases with the power of the gun.…”

Section: Introductionmentioning

confidence: 99%

The Association of Firearm Caliber With Likelihood of Death From Gunshot Injury in Criminal Assaults

Braga

Cook

2018

JAMA Netw Open

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Key Points Question Is there an association between the likelihood of death for firearms shooting victims and the caliber of the firearm? Findings A cross-sectional study using 5 years of data extracted from investigation files kept by the Boston Police Department determined that the case-fatality rates of assaults inflicting gunshot injury increased significantly with the caliber of the firearm. Caliber was not significantly correlated with other observable characteristics of the assault, including indicators of intent and determination to kill. Meaning The findings are foundational to the debate over whether deadly weapons should be better regulated and provide evidence against the common view that whether the victim lives or dies is determined largely by the assailant’s intent and not the type of weapon.

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“…1,2 Despite these efforts, deaths from injury have increased in the United States over the last decade relative to other causes of mortality. 3,4 Looking forward, in order to make strides in trauma outcomes this high mortality of severe injuries must be mitigated.…”

Section: Introductionmentioning

confidence: 99%