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Firearm assault injuries by residence and injury occurrence location.

ABSTRACT: Research on spatial injury patterns is limited by a lack of precise injury occurrence location data. Using linked hospital and death records, we examined residence and injury locations for firearm assaults and homicides in or among residents of King County, Washington, USA from 1 January 2010 to 31 December 2014. In total, 670 injuries were identified, 586 with geocoded residence and injury locations. Three-quarters of injuries occurred outside the census tract where the victim resided. Median distance between locations was 3.9 miles, with victims 18-34 having the greatest distances between residence and injury location. 40 of 398 tracts had a ratio of injury incidents to injured residents of >1. Routine collection of injury location data and homelessness status could decrease misclassification and bias. Researchers should consider whether residential address is an appropriate proxy for injury location, based on data quality and their specific research question.

SUBMITTER: Mills B

PROVIDER: S-EPMC7526511 | biostudies-literature | 2019 Sep

REPOSITORIES: biostudies-literature

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Firearm assault injuries by residence and injury occurrence location.

Mills Brianna B Hajat Anjum A Rivara Frederick F Nurius Paula P Matsueda Ross R Rowhani-Rahbar Ali A

Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention 20190330 Suppl 1

Research on spatial injury patterns is limited by a lack of precise injury occurrence location data. Using linked hospital and death records, we examined residence and injury locations for firearm assaults and homicides in or among residents of King County, Washington, USA from 1 January 2010 to 31 December 2014. In total, 670 injuries were identified, 586 with geocoded residence and injury locations. Three-quarters of injuries occurred outside the census tract where the victim resided. Median d ...[more]

PMID: 30928914

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Project description:ImportancePediatric firearm injuries are a serious and growing public health problem, constituting the second leading cause of death in children and adolescents in the United States. Firearm injuries have a high case fatality, but knowledge is limited to date regarding their injury severity and health care utilization burden compared with those of other penetrating injuries, especially among children with critical injury.ObjectiveTo describe and compare the resource utilization, injury severity, and short-term clinical outcomes associated with pediatric firearm injuries and other penetrating trauma.Design, setting, and participantsThis retrospective cohort study used data from the National Trauma Data Bank, an encounter-level registry of trauma data in the United States, from January 1, 2007, to December 31, 2016. Encounters for firearm injury (n?=?25?155) or cut or pierce injury (21?270) in children 17 years or younger were analyzed. Statistical analysis was conducted from July 15, 2018, to June 5, 2019.ExposuresFirearm injury compared with cut or pierce injury encounters.Main outcomes and measuresIntensive care unit (ICU) admission, hospital and ICU length of stay (LOS), and Injury Severity Score (ISS).ResultsA total of 25?155 firearm injury encounters and 21?270 cut or pierce injury encounters were analyzed. Most firearm and cut or pierce injuries occurred among boys (21?573 [85.8%] and 15?864 [74.6%]) and adolescents aged 15 to 17 years (18 807 [74.8%] and 10?895 [51.2%]). A greater proportion of those with firearm injuries were African American children compared with those with cut or pierce injuries (15?019 [61.3%] vs 6397 [31.2%]). A greater proportion of those with firearm injuries compared with cut or pierce injuries were admitted to the ICU (7682 [30.5%] vs 2712 [12.8%]). Compared with cut or pierce injuries, firearm injuries were associated with a higher mean (SD) ISS (4.6 [6.8] vs 10.9 [12.7] points), longer mean (SD) hospital LOS (2.8 [4.1] vs 5.0 [8.4] days), and longer mean (SD) ICU LOS (3.1 [4.5] vs 5.1 [7.7] days). Firearm injuries accounted for 126?027 hospital days and 39?255 ICU days, whereas cut or pierce injuries accounted for 58?705 hospital days and 8353 ICU days. After adjustments for age, sex, year, and hospital, those with firearm injuries were more likely to require ICU admission (relative risk [RR], 2.3; 95% CI, 2.1-2.5; P?<?.001) and to have higher ISS scores (6.7 points higher for all injuries; 95% CI, 6.1-7.2) compared with those with cut or pierce injuries, even among critical injuries. Multinomial logistic regression demonstrated higher risk of prolonged hospital LOS (RR ratio,?4.11; 95% CI, 3.46-4.89; P?<?.001) and ICU LOS (RR ratio, 2.2;?95% CI, 1.9-2.3) for firearm injuries compared with cut or pierce injuries.Conclusions and relevanceThis study found that pediatric firearm injuries were associated with greater severity and health care utilization compared with penetrating trauma from other mechanisms, suggesting that the mechanism of injury is an important consideration in penetrating sharp force trauma in children and adolescents. Public health measures, legislative efforts, and safe storage practices are among the interventions needed to reduce pediatric firearm injuries.

Dataset Information

Firearm assault injuries by residence and injury occurrence location.

Publications

Firearm assault injuries by residence and injury occurrence location.

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