Vos Saskia R, Sumner Steven A, Fowler Katherine A, Blair Janet M, Bowen Daniel A
National Centers for Injury Control and Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia.
National Centers for Injury Control and Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia.
Am J Prev Med. 2025 Jul;69(1):107632. doi: 10.1016/j.amepre.2025.04.002. Epub 2025 Apr 10.
A complex and ongoing issue in firearm violence prevention research is correctly classifying injury intent (e.g., homicide, suicide, or unintentional). Emerging rule-based approaches to improve classification use the number of bullet wounds to infer intent of the injury when additional information is not available. Using the Centers for Disease Control and Prevention's National Violent Death Reporting System (NVDRS), which captures detailed information on intent of firearm injuries from coroner/medical examiner reports, law enforcement reports, and death certificates, this study examined potential evidence to support intent determination based on the number of bullet wounds.
2003-2021 NVDRS data on fatal firearm injuries was analyzed in 2023. ANOVA was used to test statistical significance of differences in average number of bullet wounds by intent, and Tukey's Honest Significant Difference Test was used to determine specific differences by intent.
A total of 299,362 fatal firearm injury decedents were identified. The average number of bullet wounds significantly differed by intent: suicide, 1.02; homicide, 2.72; and unintentional injury, 1.01 (p<0.01). Homicide decedents had a significantly higher average number of wounds than unintentional injury decedents and suicide decedents (ΔM homicide-unintentional injury [1.71; 95% CI=1.62, 1.79; p<0.01] and ΔM homicide-suicide [1.70; 95% CI=1.68, 1.72; p<0.01]).
The number of bullet wounds may be a useful indicator for classifying intent of firearm injuries, particularly for interpersonal assault, and when other supporting information is not available for medical coding. Accurate counts of firearm injuries by intent are critical for public health surveillance and prevention planning.
枪支暴力预防研究中一个复杂且持续存在的问题是正确分类伤害意图（例如，他杀、自杀或意外伤害）。当无法获取其他信息时，新兴的基于规则的方法通过枪伤数量来推断伤害意图，以改进分类。本研究利用疾病控制与预防中心的国家暴力死亡报告系统（NVDRS），该系统从验尸官/法医报告、执法报告和死亡证明中获取有关枪支伤害意图的详细信息，研究了基于枪伤数量支持意图判定的潜在证据。
2023年对2003 - 2021年NVDRS中致命枪支伤害数据进行了分析。方差分析用于检验不同意图下平均枪伤数量差异的统计学显著性，Tukey诚实显著性差异检验用于确定不同意图下的具体差异。
共识别出299,362例致命枪支伤害死者。平均枪伤数量因意图而异：自杀为1.02；他杀为2.72；意外伤害为1.01（p<0.01）。他杀死者的平均伤口数量显著高于意外伤害死者和自杀死者（他杀与意外伤害的平均差值[1.71；95%置信区间=1.62, 1.79；p<0.01]，他杀与自杀的平均差值[1.70；95%置信区间=1.68, 1.72；p<0.01]）。
枪伤数量可能是分类枪支伤害意图的有用指标，特别是对于人际攻击，并且在医疗编码无法获取其他支持信息时。按意图准确统计枪支伤害对于公共卫生监测和预防规划至关重要。
