Spitzer Sarabeth, Castillo-Angeles Manuel, Thomas Arielle, Hey Matthew, D'Souza Karan, Jarman Molly P, Anderson Geoffrey A
American College of Surgeons, 633 N Saint Clair Street, Chicago, IL 61611, United States.
Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI 53226, United States.
Surg Pract Sci. 2022 Sep 28;11:100130. doi: 10.1016/j.sipas.2022.100130. eCollection 2022 Dec.
Firearm injuries' association with individual-level socioeconomic risk is well described. Trauma research has suggested that neighborhood level risk factors may be associated with differences in firearm injury outcome. We analyzed the relationship between hospital length of stay (LOS), mortality and neighborhood level social markers from the Center for Disease Control (CDC) Social Vulnerability Index (SVI) after firearm injury.
We used the Healthcare Cost and Utilization Project (HCUP) State Inpatient Database (SID) in 2016 to identify firearm injuries using ICD-10 E-codes. Patient locations were identified at the census tract level. The 2016 CDC SVI was used to evaluate neighborhood level social vulnerability. Logistic and linear multivariable regression were used to evaluate the association between SVI percentile rank, mortality, and LOS.
We identified 9,764 cases of firearm injury in our database; 88.2% of individuals were male, and the average age was 33.8 years. Assault was the most common intent, accounting for 4682 (48.0%) of all admissions. Overall, SVI was correlated with the risk of firearm injury, but not associated with either outcome of length of stay or risk of death.
While there is significant disparity between SVI and risk of firearm injury, once admitted to the hospital outcomes are similar between low and high-vulnerable populations. To reduce disparities in risk, funding and effort should focus on primary prevention.
枪支伤害与个人层面的社会经济风险之间的关联已得到充分描述。创伤研究表明，社区层面的风险因素可能与枪支伤害结果的差异有关。我们分析了枪支伤害后，住院时间（LOS）、死亡率与来自疾病控制中心（CDC）社会脆弱性指数（SVI）的社区层面社会指标之间的关系。
我们使用2016年医疗成本与利用项目（HCUP）的州住院数据库（SID），通过ICD - 10电子编码识别枪支伤害。在普查区层面确定患者位置。使用2016年CDC的SVI评估社区层面的社会脆弱性。采用逻辑回归和线性多变量回归评估SVI百分位排名、死亡率和住院时间之间的关联。
我们在数据库中识别出9764例枪支伤害病例；88.2%的患者为男性，平均年龄为33.8岁。袭击是最常见的致伤意图，占所有入院病例的4682例（48.0%）。总体而言，SVI与枪支伤害风险相关，但与住院时间或死亡风险的结果均无关联。
虽然SVI与枪支伤害风险之间存在显著差异，但一旦入院，低脆弱性人群和高脆弱性人群的治疗结果相似。为减少风险差异，资金和工作应集中在一级预防上。
