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- Title
Injury Characteristics, Outcomes, and Health Care Services Use Associated With Nonfatal Injuries Sustained in Mass Shootings in the US, 2012-2019.
- Authors
Czaja, Matthew P.; Kraus, Chadd K.; Phyo, Su; Olivieri, Patrick; Mederos, Dalier R.; Puente, Ivan; Mohammed, Salman; Berkeley, Ross P.; Slattery, David; Gildea, Thomas H.; Hardman, Claire; Palmer, Brandi; Whitmill, Melissa L.; Aluyen, Una; Pinnow, Jeffery M.; Young, Amanda; Eastin, Carly D.; Kester, Nurani M.; Works, Kaitlyn R.; Pfeffer, Andrew N.
- Abstract
Key Points: Question: What are the injury characteristics, outcomes, and health care services use among patients who have sustained nonfatal injuries in civilian public mass shootings? Findings: In this case series of 403 patients who sustained nonfatal injuries in 13 consecutive mass shootings (defined as ≥10 individuals injured) from 31 hospitals in the US (2012-2019), 252 patients (62.5%) had firearm injuries, 147 (36.5%) were admitted to a hospital, 148 (40.7%) underwent emergency department procedures, 95 (23.6%) underwent 1 surgical procedure, and 42 (10.4%) underwent multiple surgical procedures. Meaning: These findings suggest that the overall burden of mass shootings should not be limited to the number of deaths but should also incorporate nonfatal injuries, including those due to firearms and other trauma. This case series evaluates the injury characteristics, outcomes, and resource use among individuals who have sustained nonfatal injuries in civilian public mass shootings. Importance: Civilian public mass shootings (CPMSs) in the US result in substantial injuries. However, the types and consequences of these injuries have not been systematically described. Objective: To describe the injury characteristics, outcomes, and health care burden associated with nonfatal injuries sustained during CPMSs and to better understand the consequences to patients, hospitals, and society at large. Design, Setting, and Participants: This retrospective case series of nonfatal injuries from 13 consecutive CPMSs (defined as ≥10 injured individuals) from 31 hospitals in the US from July 20, 2012, to August 31, 2019, used data from trauma logs and medical records to capture injuries, procedures, lengths of stay, functional impairment, disposition, and charges. A total of 403 individuals treated in hospitals within 24 hours of the CPMSs were included in the analysis. Data were analyzed from October 27 to December 5, 2021. Exposures: Nonfatal injuries sustained during CPMSs. Main Outcomes and Measures: Injuries and diagnoses, treating services, procedures, hospital care, and monetary charges. Results: Among the 403 individuals included in the study, the median age was 33.0 (IQR, 24.5-48.0 [range, 1 to >89]) years, and 209 (51.9%) were women. Among the 386 patients with race and ethnicity data available, 13 (3.4%) were Asian; 44 (11.4%), Black or African American; 59 (15.3), Hispanic/Latinx; and 270 (69.9%), White. Injuries included 252 gunshot wounds (62.5%) and 112 other injuries (27.8%), and 39 patients (9.7%) had no physical injuries. One hundred seventy-eight individuals (53.1%) arrived by ambulance. Of 494 body regions injured (mean [SD], 1.35 [0.68] per patient), most common included an extremity (282 [57.1%]), abdomen and/or pelvis (66 [13.4%]), head and/or neck (65 [13.2%]), and chest (50 [10.1%]). Overall, 147 individuals (36.5%) were admitted to a hospital, 95 (23.6%) underwent 1 surgical procedure, and 42 (10.4%) underwent multiple procedures (1.82 per patient). Among the 252 patients with gunshot wounds, the most common initial procedures were general and trauma surgery (41 [16.3%]) and orthopedic surgery (36 [14.3%]). In the emergency department, 148 of 364 injured individuals (40.7%) had 199 procedures (1.34 per patient). Median hospital length of stay was 4.0 (IQR, 2.0-7.5) days; for 50 patients in the intensive care unit, 3.0 (IQR, 2.0-8.0) days (13.7% of injuries and 34.0% of admissions). Among 364 injured patients, 160 (44.0%) had functional disability at discharge, with 19 (13.3%) sent to long-term care. The mean (SD) charges per patient were $64 976 ($160 083). Conclusions and Relevance: Civilian public mass shootings cause substantial morbidity. For every death, 5.8 individuals are injured. These results suggest that including nonfatal injuries in the overall burden of CPMSs may help inform public policy to prevent and mitigate the harm caused by such events.
- Subjects
GUNSHOT wounds; EVALUATION of medical care; SHOOTINGS (Crime); DISASTERS; SEVERITY of illness index; MEDICAL care use; DESCRIPTIVE statistics; MASS casualties; DATA analysis software
- Publication
JAMA Network Open, 2022, Vol 5, Issue 5, pe2213737
- ISSN
2574-3805
- Publication type
Article
- DOI
10.1001/jamanetworkopen.2022.13737