Investigation Performed at the Emory Clinic, Atlanta, GA, USA.
Department of Orthopaedic Surgery, Emory University, 59 S Executive Park NW, Atlanta, GA, 30329, USA.
Eur J Orthop Surg Traumatol. 2023 May;33(4):1173-1178. doi: 10.1007/s00590-022-03258-3. Epub 2022 Apr 29.
Civilian gun violence is a public health crisis in the USA that will be an economic burden reported to be as high as $17.7 billion with over half coming from US taxpayers dollars through Medicaid-related costs. The purpose of this study is to review the epidemiology of upper extremity firearm injuries in the USA and the associated injury burden.
The Inter-university Consortium for Political and Social Research's Firearm Injury Surveillance Study database, collected from the National Electronic Injury Surveillance System, was queried from 1993 to 2015. The following variables were reviewed: patient demographics, date of injury, diagnosis, injury location, firearm type (if provided), incident classification, and a descriptive narrative of the incident. We performed chi-square testing and complex descriptive statistics, and binomial logistic regression model to predict factors associated with hospital admission.
From 1993 to 2015, an estimated 314,369 (95% CI: 291,528-337,750; 16,883 unweighted) nonfatal firearm upper extremity injuries with an average incidence rate of 4.76 per 100,000 persons (SD: 0.9; 03.77-7.49) occurred. The demographics most afflicted with nonfatal gunshot wound injuries were black adolescent and young adult males (ages 15-24 years). Young adults aged 25-34 were the second largest estimate of injuries by age group. Hands were the most commonly injured upper extremity, (55,014; 95% CI: 75,973-89,667) followed by the shoulder, forearm, and upper arm. Patients who underwent amputation (OR: 28.65; 95% CI: 24.85-33.03) or with fractures (OR: 26.20; 95% CI: 23.27-29.50) experienced an increased likelihood for hospitalization. Patients with a shoulder injury were 5.5× more likely to be hospitalized than those with a finger injury (OR:5.57; 95% CI:5.35-5.80). The incidence of upper extremity firearm injuries has remained steady over the last decade ranging between 4 and 5 injuries per 100,000 persons. Patients with proximal injuries or injuries involving the bone were more likely to require hospital admission. This study should bring new information to the forefront for policy makers regarding gun violence.
在美国，民用枪支暴力是一场公共卫生危机，据报道，其经济负担高达 177 亿美元，其中超过一半来自美国纳税人的医疗补助相关费用。本研究的目的是回顾美国上肢火器伤的流行病学和相关的伤害负担。
从 1993 年至 2015 年，查询了跨大学政治和社会研究联合会的枪支伤害监测研究数据库（来自国家电子伤害监测系统）。审查了以下变量：患者人口统计学、受伤日期、诊断、受伤部位、枪支类型（如有提供）、事件分类以及事件的描述性叙述。我们进行了卡方检验和复杂描述性统计，以及二项逻辑回归模型来预测与住院相关的因素。
从 1993 年至 2015 年，估计有 314369 例（95%CI：291528-337750；未加权的 16883 例）非致命性上肢火器伤，平均发病率为每 100000 人 4.76 例（SD：0.9；0.377-7.49）。受非致命性枪伤影响最大的是黑人青少年和年轻成年男性（15-24 岁）。25-34 岁的年轻人是受伤人数第二大的年龄组。手部是最常见的上肢受伤部位（55014 例；95%CI：75973-89667），其次是肩部、前臂和上臂。接受截肢（OR：28.65；95%CI：24.85-33.03）或骨折（OR：26.20；95%CI：23.27-29.50）的患者更有可能住院。肩部受伤的患者住院的可能性是手指受伤患者的 5.5 倍（OR：5.57；95%CI：5.35-5.80）。在过去十年中，上肢火器伤的发病率一直稳定在每 10 万人 4 至 5 例之间。近端受伤或涉及骨骼的受伤更有可能需要住院治疗。本研究应为决策者提供有关枪支暴力的新信息。
