Temporal variation in United States firearm injuries 1993-2008: results from a national data base

Firearm Injuries during Pregnancy in the USA

Trauma during pregnancy is the leading cause of non-pregnancy-related maternal deaths, with some due to injuries from firearms. It was the purpose of this study to characterize the patterns and presentations of firearm-associated injuries in pregnant women using a national emergency department visit database. Data from the Inter-University Consortium for Political and Social Research Firearm Injury Surveillance Study 1993-2020 were utilized. The data include age, sex, race, type of firearm, perpetrator of injury, intent of injury (unintentional, assault, suicide, or law enforcement), anatomic location of the injury, incident locale, disposition from the emergency department (ED), and whether the patient was shot or not with the firearm. Of the 3.36 million ED visits over this time span for firearm injuries, 4410 were pregnant women. The mean age of the pregnant cohort was 23.6 years, with more Hispanic and fewer White women in the pregnant group compared to the non-pregnant cohort. Pregnant women were more likely to experience an injury involving the lower trunk and had a higher percentage of fatalities and hospital admissions compared to the non-pregnant cohort. Fetal demise occurred in at least 70% of cases. Nearly one half of the assaults (44%) occurred on Saturdays and Sundays. As the cause of these injuries is complex, prevention will require input from multiple sources, including health care providers, social agencies, government agencies, elected officials, and law enforcement.

Fractures in Children Due to Firearm Activity

The purpose of this study was to investigate fracture patterns due to pediatric firearm injuries. The data used was from the US Firearm Injury Surveillance Study 1993–2019. Over these 27 years, there were 19,033 children with fractures due to firearm activity with an average age of 12.2 years; 85.2% were boys and the firearm was a powder type in 64.7%. The finger was the most common fracture location, while the tibia/fibula was the most common location for those admitted to the hospital. Children ≤ 5 years of age sustained more skull/face fractures; most spine fractures occurred in the 11–15-year age group. The injury was self-inflicted in 65.2% of the non-powder and 30.6% of the powder group. The injury intent was an assault in 50.0% of the powder and 3.7% of the non-powder firearm group. Powder firearms accounted for the majority of the fractures in the ≤5 and 11–15 year-olds, non-powder firearms accounted for the majority of the fractures in the 6–10 year-olds. Injuries occurring at home decreased with increasing age; there was an increase in hospital admissions over time. In conclusion, our findings support the need for safe storage of firearms in the home away from children. This data will be helpful to assess any changes in prevalence or demographics with future firearm legislation or other prevention programs. The increasing acuity of firearm-associated injuries seen in this study is detrimental to the child, impacts familial wellbeing, and results in significant financial costs to society.

Trends in pediatric firearm-related injuries over the past 10 years at an urban pediatric hospital

PURPOSE

Firearm injuries are the second most common cause of trauma deaths in American children. We reviewed gunshot wounds treated at an urban children's hospital to determine the most likely time for injuries to occur over 10 years.

METHODS

A retrospective chart review was completed for patients with a firearm injury from January 2003 to December 2012. Patients were excluded if over 17 years or readmitted. Demographics, injury circumstances, interventions, and outcomes were reviewed for 289 patients. Chi square and ANOVA analyses were completed. Alpha was chosen as p<0.05.

RESULTS

Mean age was 12 years, 74% were male and 80% African American. Unintentional injuries occurred in 26% and violence related in 72%. The most common months of injury were August and June, the least common November and October. Unintentional injuries were more likely to occur during the day and violence related injuries were more likely at night (p=0.01). The incidence was lowest 2008-2010 and highest in 2006 and 2011. Mortality was 3.5%.

CONCLUSIONS

We noted an increasing incidence of pediatric firearm related injuries in the last two years of the study with over half requiring operative intervention. Most injuries were violence related and occurred in a large city during summer months.

If hunters end up in the emergency room: a retrospective analysis of hunting injuries in a swiss emergency department

Aim. to characterize the mechanisms, patterns, and outcomes of nonfatal hunting-related injuries in patients presenting to Bern University Hospital, Switzerland, and compare these to reports of hunting injuries worldwide. Methods. patients presenting with hunting-related injuries to the Emergency Department at Bern University hospital from 2000 to 2014 were identified by retrospectively searching the department database using the keyword “hunt.” Each case was analyzed in terms of the patient age and gender, the mechanism and pattern of injury, and management and patient follow-up. Results. 19 patients were identified. 16 were male with a mean age of 50 years (range: 16–74). Mechanisms of injury included firearm-related injuries, falls, and knife wounds. The most common patterns of injury were head injuries (7), followed by injuries to the upper (5) or lower limb (5) and trunk (2). Over half of the patients were admitted, and nine required emergency surgery. Conclusion. Nonfatal hunting accidents in Bern, Switzerland, are largely caused by firearms and falls and tend to occur in male hunters with a mean age of 50 years. The most common patterns of injury are orthopedic and head injuries, often requiring surgery. These findings are consistent with international studies of nonfatal hunting accidents.