Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #117433

Cameron S. Crandall, MD¹, Jonathon LaValley, BS¹, Roberto Aguero, MS¹, and Lynne Fullerton-Gleason, PhD². (1) Department of Emergency Medicine, University of New Mexico, Center for Injury Prevention Research and Education, ACC 4-W, Albuquerque, NM 87131-5246, (2) Trauma Institute, University of Nevada School of Medicine, 2040 W. Charleston Blvd, Suite 501, Las Vegas, NV 89102, 702-671-2276, lfullerton@salud.unm.edu

Case-control studies demonstrate an association of violent death and firearm ownership, but prospective data are limited. We sought to determine if violent mortality risks for a cohort of patients seen in the emergency department (ED) for a firearm injury were higher than patients without prior firearm injury. Nonconcurrent prospective cohort data from a university-affiliated urban ED (2/94–11/04) were probabilistically linked to state mortality records. Patients with ED visits for firearm injury (‘exposed') (N=467) were compared to patients without (‘unexposed') (N=217,837). Exposure was determined from billing diagnoses, E-codes and free text searching of the ED tracking system data for ‘gunshot wound,' ‘GSW' and spelling variants. Deaths within 7 days of the firearm injury were presumed related to the original injury and did not count as prior exposure. The principal outcome was violent death. Relative risk (RR) and 95% confidence intervals (CI) were calculated from contingency table analyses. Over the average follow-up of 6.0 years, there were 35 deaths among the firearm-exposed cohort. 25 were violent (5.4%) and 18 of these (72%) were firearm-related. In patients without firearm-related injury, there were 6,432 deaths. 772 were violent (0.4%) and 409 of these (53%) were firearm-related (RR violent death: 15.1; CI: 10.3–22.3). Both homicide (RR: 18.3; CI: 10.7–31.5) and suicide (RR: 13.1; CI: 7.1–23.1) risks were greater. ED patients with nonfatal firearm-related injury are at substantially greater risk of subsequent violent death compared to other ED patients, emphasizing the need to intervene with this high risk group.

Learning Objectives:

• 1. Describe the risk of violent death following an emergency department visit for a firearm injury.
• 2. Understand the need for targeted intervention among patients who have a firearm injury for any reason.

Keywords: Firearms, Violence Prevention

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.