Lee R K, Waxweiler R J, Dobbins J G, Paschetag T
University of Texas School of Nursing, University of Texas Medical Branch, Galveston 77550.
Am J Epidemiol. 1991 Sep 1;134(5):511-21. doi: 10.1093/oxfordjournals.aje.a116123.
Firearm injury mortality rates have been characterized in various settings, but little is known of the total magnitude of firearm injury, including morbidity. The authors determined population-based incidence rates of firearm injury among residents of Galveston, Texas, from 1979-1981 by using police, emergency department, hospital, emergency medical services, medical examiner, and vital records to identify 239 firearm injury cases. Vital records, medical examiner, and police records each identified more than 95% of the fatalities, but police records (sensitivity = 98%) were better than emergency department or hospital records (sensitivity = 82% and 28%, respectively) for identifying all nonfatal cases. The annual age-adjusted incidence rate of firearm injury was 128 per 100,000 persons. Black males, with the highest firearm injury rate (459 per 100,000 persons), were injured at 46 times the rate of white females (10 per 100,000 persons). The overall case fatality rate was 30%, including 25% of the assaults/homicides, 81% of the parasuicides/suicides, and 0% of the unintentional injuries. On the basis of the case fatality rates, an estimated 140,000 firearm injuries occur in the United States annually. The case fatality rate for penetrating head injuries was 80% versus 48% for chest injuries and 6% for all other parts of the body. The results are discussed with respect to policy recommendations for reducing firearm injuries.
枪支伤害死亡率在不同环境中已有特征描述，但对于包括发病率在内的枪支伤害的总体规模却知之甚少。作者通过利用警方、急诊科、医院、紧急医疗服务部门、法医和生命记录来确定1979 - 1981年期间得克萨斯州加尔维斯顿居民中基于人群的枪支伤害发病率，共识别出239例枪支伤害病例。生命记录、法医记录和警方记录各自识别出了超过95%的死亡病例，但在识别所有非致命病例方面，警方记录（敏感度 = 98%）优于急诊科或医院记录（敏感度分别为82%和28%）。枪支伤害的年龄调整后年发病率为每10万人128例。黑人男性的枪支伤害率最高（每10万人459例），是白人女性（每10万人10例）的46倍。总体病死率为30%，其中攻击/杀人案件的病死率为25%，准自杀/自杀案件的病死率为81%，意外伤害案件的病死率为0%。根据病死率估算，美国每年发生约14万起枪支伤害事件。穿透性头部损伤的病死率为80%，胸部损伤为48%，身体其他部位为6%。文中还就减少枪支伤害的政策建议对研究结果进行了讨论。
