Gunshot victims at a major level i trauma center: A study of 343,866 emergency department visits

Background: Disturbing trends regarding the sex, age, and race of gunshot victims have been reported in previous national studies; however, gunshot trends have not been well documented in individual cities in the southeastern United States. Objectives: 1) Analyze trends in gunshot wounds, particularly the association between gunshot wounds and race, among victims presenting to a Level I Trauma Center in Middle Tennessee; 2) Compare specific characteristics of gunshot victims to the general Emergency Department (ED) population. Methods: This is a retrospective cohort study of 343,866 ED visits from 2004 to 2009. Results: Compared to the general ED population, gunshot victims were more predominantly male (87.5% vs. 43.4%), black (57.6% vs. 29.5%), younger (47.8% under age 25 years vs. 31.6%), and demonstrated higher Medicaid enrollment (78.6% vs. 44.7%). The majority of black gunshot victims were aged 18-25 years (47.1%) and victims of assault (65.9%). Non-black gunshot victims suffered more unintentional (40.2% vs. 28.2%) and self-inflicted (9.1% vs. 0.4%) injuries and were more evenly distributed among ages 18-55 years. Black patients were 3.03 (95% confidence interval 2.93-3.14) times more likely to present to this ED for gunshot wounds than non-black patients, after controlling for age, sex, and insurance status (p <0.001). Conclusions: Our study demonstrates that black patients between 18 and 25 years of age presenting to this trauma center are more likely to be victims of gun violence than their non-black counterparts. Our study evaluates trends in gun violence in the Southeast, particularly in relation to race, age, and insurance status.