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Firearm assault in Philadelphia, 2005–2014: a comparison of police and trauma registry data
BACKGROUND: Firearm injury is a major public health burden in the USA. Absent a single, reliable data source, researchers have attempted to describe firearm injury epidemiology using trauma registry data. To understand the implications of this approach, we compared trends in firearm assault incidenc...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6699718/ https://www.ncbi.nlm.nih.gov/pubmed/31467983 http://dx.doi.org/10.1136/tsaco-2019-000316 |
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author | Kaufman, Elinore Holena, Daniel N Yang, Wei P Morrison, Christopher N Jacoby, Sara F Seamon, Mark Sims, Carrie Wiebe, Douglas J Beard, Jessica H |
author_facet | Kaufman, Elinore Holena, Daniel N Yang, Wei P Morrison, Christopher N Jacoby, Sara F Seamon, Mark Sims, Carrie Wiebe, Douglas J Beard, Jessica H |
author_sort | Kaufman, Elinore |
collection | PubMed |
description | BACKGROUND: Firearm injury is a major public health burden in the USA. Absent a single, reliable data source, researchers have attempted to describe firearm injury epidemiology using trauma registry data. To understand the implications of this approach, we compared trends in firearm assault incidence and case-fatality in Philadelphia over 10 years from two sources: the Pennsylvania Trauma Outcomes Study (PTOS), Pennsylvania’s state-mandated trauma registry, and the Philadelphia Police Department database (PPD) of firearm assaults. METHODS: We included PTOS firearm assault patients treated in Philadelphia County and PPD database firearm assault victims from 2005 to 2014. We calculated counts of fatal and non-fatal incidents using PTOS and PPD data. We used generalized linear models adjusted for seasonality to estimate temporal trends in firearm assault rates and case-fatality for both data sources and compared patient demographics and injury characteristics between the two. RESULTS: A total of 6988 PTOS and 14 172 PPD subjects met the inclusion criteria. In both data sets, firearm assault rates decreased significantly during the study period (PTOS: 5.19 vs. 3.43 per 10 000 person-years, change/year: −0.21, 95% CI −0.26 to –0.16; PPD: 10.97 vs. 6.70 per 10 000 person-years, change/year: −0.53, 95% CI −0.62 to –0.44). PTOS mean case-fatality rate was 26.5% and decreased significantly (change/year: −0.41, 95% CI −0.78% to 0.04%). PPD mean case-fatality rate was 18.9% with no significant change over time (p=0.41). DISCUSSION: Relative to PPD data, PTOS data underestimated firearm assault incidence and overestimated mortality. Trends in case-fatality rates were disparate across the two data sources. A true understanding of firearm injury in the USA requires comprehensive data collection on the incidence, nature, and severity of these injuries. As trauma registry data are by definition incomplete, combining data sources is essential. Local law enforcement data are an important potential source for studying city-level firearm injury. LEVEL OF EVIDENCE: Level III, epidemiological. |
format | Online Article Text |
id | pubmed-6699718 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-66997182019-08-29 Firearm assault in Philadelphia, 2005–2014: a comparison of police and trauma registry data Kaufman, Elinore Holena, Daniel N Yang, Wei P Morrison, Christopher N Jacoby, Sara F Seamon, Mark Sims, Carrie Wiebe, Douglas J Beard, Jessica H Trauma Surg Acute Care Open Original Article BACKGROUND: Firearm injury is a major public health burden in the USA. Absent a single, reliable data source, researchers have attempted to describe firearm injury epidemiology using trauma registry data. To understand the implications of this approach, we compared trends in firearm assault incidence and case-fatality in Philadelphia over 10 years from two sources: the Pennsylvania Trauma Outcomes Study (PTOS), Pennsylvania’s state-mandated trauma registry, and the Philadelphia Police Department database (PPD) of firearm assaults. METHODS: We included PTOS firearm assault patients treated in Philadelphia County and PPD database firearm assault victims from 2005 to 2014. We calculated counts of fatal and non-fatal incidents using PTOS and PPD data. We used generalized linear models adjusted for seasonality to estimate temporal trends in firearm assault rates and case-fatality for both data sources and compared patient demographics and injury characteristics between the two. RESULTS: A total of 6988 PTOS and 14 172 PPD subjects met the inclusion criteria. In both data sets, firearm assault rates decreased significantly during the study period (PTOS: 5.19 vs. 3.43 per 10 000 person-years, change/year: −0.21, 95% CI −0.26 to –0.16; PPD: 10.97 vs. 6.70 per 10 000 person-years, change/year: −0.53, 95% CI −0.62 to –0.44). PTOS mean case-fatality rate was 26.5% and decreased significantly (change/year: −0.41, 95% CI −0.78% to 0.04%). PPD mean case-fatality rate was 18.9% with no significant change over time (p=0.41). DISCUSSION: Relative to PPD data, PTOS data underestimated firearm assault incidence and overestimated mortality. Trends in case-fatality rates were disparate across the two data sources. A true understanding of firearm injury in the USA requires comprehensive data collection on the incidence, nature, and severity of these injuries. As trauma registry data are by definition incomplete, combining data sources is essential. Local law enforcement data are an important potential source for studying city-level firearm injury. LEVEL OF EVIDENCE: Level III, epidemiological. BMJ Publishing Group 2019-08-12 /pmc/articles/PMC6699718/ /pubmed/31467983 http://dx.doi.org/10.1136/tsaco-2019-000316 Text en © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. |
spellingShingle | Original Article Kaufman, Elinore Holena, Daniel N Yang, Wei P Morrison, Christopher N Jacoby, Sara F Seamon, Mark Sims, Carrie Wiebe, Douglas J Beard, Jessica H Firearm assault in Philadelphia, 2005–2014: a comparison of police and trauma registry data |
title | Firearm assault in Philadelphia, 2005–2014: a comparison of police and trauma registry data |
title_full | Firearm assault in Philadelphia, 2005–2014: a comparison of police and trauma registry data |
title_fullStr | Firearm assault in Philadelphia, 2005–2014: a comparison of police and trauma registry data |
title_full_unstemmed | Firearm assault in Philadelphia, 2005–2014: a comparison of police and trauma registry data |
title_short | Firearm assault in Philadelphia, 2005–2014: a comparison of police and trauma registry data |
title_sort | firearm assault in philadelphia, 2005–2014: a comparison of police and trauma registry data |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6699718/ https://www.ncbi.nlm.nih.gov/pubmed/31467983 http://dx.doi.org/10.1136/tsaco-2019-000316 |
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