Journal article
Nonfatal Injuries Sustained in Mass Shootings in the US, 2012-2019: Injury Diagnosis Matrix, Incident Context, and Public Health Considerations
The western journal of emergency medicine, Vol.24(3), pp.552-565
05/01/2023
DOI: 10.5811/westjem.58395
PMCID: PMC10284525
PMID: 37278791
Abstract
The epidemic of gun violence in the United States (US) is exacerbated by frequent mass shootings. In 2021, there were 698 mass shootings in the US, resulting in 705 deaths and 2,830 injuries. This is a companion paper to a publication in JAMA Network Open, in which the nonfatal outcomes of victims of mass shootings have been only partially described.
We gathered clinical and logistic information from 31 hospitals in the US about 403 survivors of 13 mass shootings, each event involving greater than 10 injuries, from 2012-19. Local champions in emergency medicine and trauma surgery provided clinical data from electronic health records within 24 hours of a mass shooting. We organized descriptive statistics of individual-level diagnoses recorded in medical records using International Classification of Diseases codes, according to the Barell Injury Diagnosis Matrix (BIDM), a standardized tool that classifies 12 types of injuries within 36 body regions.
Of the 403 patients who were evaluated at a hospital, 364 sustained physical injuries-252 by gunshot wound (GSW) and 112 by non-ballistic trauma-and 39 were uninjured. Fifty patients had 75 psychiatric diagnoses. Nearly 10% of victims came to the hospital for symptoms triggered by, but not directly related to, the shooting, or for exacerbations of underlying conditions. There were 362 gunshot wounds recorded in the Barell Matrix (1.44 per patient). The Emergency Severity Index (ESI) distribution was skewed toward higher acuity than typical for an emergency department (ED), with 15.1% ESI 1 and 17.6% ESI 2 patients. Semi-automatic firearms were used in 100% of these civilian public mass shootings, with 50 total weapons for 13 shootings (Route 91 Harvest Festival, Las Vegas. 24). Assailant motivations were reported to be associated with hate crimes in 23.1%.
Survivors of mass shootings have substantial morbidity and characteristic injury distribution, but 37% of victims had no GSW. Law enforcement, emergency medical systems, and hospital and ED disaster planners can use this information for injury mitigation and public policy planning. The BIDM is useful to organize data regarding gun violence injuries. We call for additional research funding to prevent and mitigate interpersonal firearm injuries, and for the National Violent Death Reporting System to expand tracking of injuries, their sequelae, complications, and societal costs.
Details
- Title: Subtitle
- Nonfatal Injuries Sustained in Mass Shootings in the US, 2012-2019: Injury Diagnosis Matrix, Incident Context, and Public Health Considerations
- Creators
- Matthew P Czaja - Denver Health Medical CenterChadd K Kraus - University of California, IrvineSu Phyo - Texas Tech UniversityPatrick Olivieri - University of Arkansas for Medical SciencesDalier R Mederos - Broward HealthIvan Puente - Broward Health Medical CenterSalman Mohammed - Vanderbilt University Medical CenterRoss P Berkeley - Vanderbilt University Medical CenterDavid Slattery - University of Nevada, Las VegasThomas H Gildea - Santa Clara Valley Medical CenterClaire Hardman - University of FloridaBrandi Palmer - Texas Tech UniversityMelissa L Whitmill - Denver Health Medical CenterUna Aluyen - Texas Tech University Health Sciences CenterJeffery M Pinnow - Medical Center HospitalAmanda Young - University of Arkansas for Medical SciencesCarly D Eastin - University of Arkansas for Medical SciencesNurani M Kester - Broward Health Medical CenterKaitlyn R Works - Vanderbilt University Medical CenterAndrew N Pfeffer - Vanderbilt University Medical CenterAleksander W Keller - University of Pittsburgh Medical CenterAdam Tobias - University of Pittsburgh Medical CenterBenjamin Li - Chapman UniversityBrian Yorkgitis - Texas Tech UniversitySoheil Saadat - University of California, IrvineMark I Langdorf - University of California, Irvine
- Resource Type
- Journal article
- Publication Details
- The western journal of emergency medicine, Vol.24(3), pp.552-565
- DOI
- 10.5811/westjem.58395
- PMID
- 37278791
- PMCID
- PMC10284525
- ISSN
- 1936-900X
- eISSN
- 1936-9018
- Language
- English
- Date published
- 05/01/2023
- Academic Unit
- Emergency Medicine
- Record Identifier
- 9984702942802771
Metrics
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