From the Injury Prevention Center, Yale-New Haven Hospital (P.V.), New Haven, Connecticut; Division of Trauma/Surgical Critical Care, Rutgers New Jersey Medical School (S.B.), Newark, New Jersey; Department of Trauma Services, Ventura County Medical Center (T.D.), Ventura, California; Department of Surgery, University of Central Florida College of Medicine (P.P.), Orlando, Florida; Department of Surgery, Carolinas Health Care (A.B.C), Charlotte, North Carolina; Department of Trauma, Cook County Hospital (A.D.), Chicago, Illinois; Division of Acute Care Surgical Services, Virginia Commonwealth University (S.G.), Richmond, Virginia; Acute and Critical Care Surgery, Emory University School of Medicine (W.G.), Atlanta, Georgia; Pediatric Surgery and Trauma, University of Massachusetts (M.H.), Boston, Massachusetts; Mission Trauma Services, Mission Hospitals Asheville (W.S.), Asheville, North Carolina; and Trauma, Burn, & Critical Care, University of Washington Harborview Medical Center (B.R.), Seattle, Washington.
J Trauma Acute Care Surg. 2018 Jun;84(6):1003-1011. doi: 10.1097/TA.0000000000001879.
Over 50,000 homicides and suicides occur each year. An estimated half of all US households are believed to have a firearm present, making them one of the most ubiquitous consumer products. Our goal was to determine if the manner of storage of a firearm in a home could potentially make a difference in the outcomes of intentional and unintentional injuries involving a firearm; specifically addressing the use of gun safes and devices that block/disable firearm function (trigger locks, cable locks, etc.).
A comprehensive review of the literature was performed. We used Grading of Recommendations Assessment, Development, and Evaluation methodology to assess the breadth and quality of the data specific to our Population, Intervention, Comparator, Outcomes (PICO) questions.
A total of 176 studies were initially identified, then, 120 more added after a subsequent literature review, with 97 removed as duplicates. One hundred ninety-one case reports, case series, and reviews were removed because they did not focus on prevention or did not address our comparators of interest. This left a total of two studies which merited inclusion for PICO 1, should gun locks be used to prevent firearm injuries and six studies which merited inclusion for PICO 2, should safe storage for guns be used to prevent firearm injuries.
PICO 1: We conditionally recommend that gun locks be used to prevent unintentional firearm injury. PICO 2: Because of the large effect size and the reasonable quality of available evidence with safe storage of firearms, we recommend safe storage prevent firearm-related injuries.
Systematic review, level III.
每年有超过 50000 起凶杀和自杀事件。据估计，一半的美国家庭都拥有枪支，这使它们成为最普遍的消费品之一。我们的目标是确定家庭中枪支的储存方式是否可能对涉及枪支的故意和非故意伤害的结果产生影响；具体来说，我们关注的是使用枪支保险箱和阻止/禁用枪支功能的设备（扳机锁、电缆锁等）。
我们进行了全面的文献综述。我们使用推荐评估、制定和评估方法（Grading of Recommendations Assessment, Development, and Evaluation）来评估与我们的人群、干预、比较、结局（Population, Intervention, Comparator, Outcomes，PICO）问题相关的数据的广度和质量。
最初确定了 176 项研究，然后在后续文献综述中又增加了 120 项，有 97 项因重复被剔除。191 项病例报告、病例系列和综述被剔除，因为它们不关注预防或不涉及我们感兴趣的比较。这使得总共只有两项研究符合 PICO1 的纳入标准，即是否应使用枪支锁来预防枪支伤害，以及六项研究符合 PICO2 的纳入标准，即是否应使用安全储存来预防枪支伤害。
PICO1：我们有条件地建议使用枪支锁来预防非故意的枪支伤害。PICO2：由于安全储存枪支的大效应量和可用证据的合理质量，我们建议使用安全储存来预防与枪支相关的伤害。
系统评价，三级。
