Suicide versus homicide firearm injury patterns on trauma systems in a study of the National Trauma Data Bank (NTDB)

Abstract Firearm related mortality in the USA surpassed all other developed countries. This study hypothesizes that injury patterns, weapon type, and mortality differ between suicide groups as opposed to homicide. The American College of Surgeons National Trauma Database was queried from January 201...

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Main Authors: Christopher W. Foote, Xuan-Lan Doan, Cheryl Vanier, Bianca Cruz, Babak Sarani, Carlos H. Palacio
Format: Article
Language:English
Published: Nature Portfolio 2022-09-01
Series:Scientific Reports
Online Access:https://doi.org/10.1038/s41598-022-17280-2
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author Christopher W. Foote
Xuan-Lan Doan
Cheryl Vanier
Bianca Cruz
Babak Sarani
Carlos H. Palacio
author_facet Christopher W. Foote
Xuan-Lan Doan
Cheryl Vanier
Bianca Cruz
Babak Sarani
Carlos H. Palacio
author_sort Christopher W. Foote
collection DOAJ
description Abstract Firearm related mortality in the USA surpassed all other developed countries. This study hypothesizes that injury patterns, weapon type, and mortality differ between suicide groups as opposed to homicide. The American College of Surgeons National Trauma Database was queried from January 2017 to December 2019. All firearm related injuries were included, and weapon type was abstracted. Differences between homicide and suicide groups by sex, age, race, and injury severity were compared using a Mann–Whitney test for numerical data and Fisher’s exact test for categorical data. The association between weapon type and mortality relative to suicide as opposed to homicide was assessed in Fisher’s exact tests. Significance was defined as p < 0.05. There were 100,031 homicide and 11,714 suicide subjects that met inclusion criteria. Homicides were mostly assault victims (97.6%), male (88%), African–American (62%), had less severe injury (mean (ISS) 12.07) and a median age of 20 years old (IQR: 14, 30, p < 0.01). Suicides were mostly male (83%), white (79%), had more severe injury (mean ISS 20.73), and a median age of 36 years old (IQR: 19, 54, p < 0.01). Suicide group had higher odds of head/neck (OR = 13.6) or face (OR = 5.7) injuries, with lower odds of injury to chest (OR = 0.55), abdominal or pelvic contents (OR = 0.25), extremities or pelvic girdle (OR = 0.15), or superficial soft tissue (OR = 0.32). Mortality rate was higher for suicide group (44.8%; 95% confidence interval (CI) 43.9%, 45.7%) compared to the homicide group (11.5%; 95% CI 11.3%, 11.7%). Suicide had higher mortality, more severe injuries, and more head/neck/facial injuries than homicide. Majority of suicides were with handguns.
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spelling doaj.art-c3b2e19fc45b47c48a77973aaed2aefd2022-12-22T03:18:12ZengNature PortfolioScientific Reports2045-23222022-09-011211810.1038/s41598-022-17280-2Suicide versus homicide firearm injury patterns on trauma systems in a study of the National Trauma Data Bank (NTDB)Christopher W. Foote0Xuan-Lan Doan1Cheryl Vanier2Bianca Cruz3Babak Sarani4Carlos H. Palacio5McAllen Medical Center, South Texas Health SystemMcAllen Medical Center, South Texas Health SystemSchool of Medicine, Touro UniversityMcAllen Medical Center, South Texas Health SystemTrauma Department, George Washington UniversityMcAllen Medical Center, South Texas Health SystemAbstract Firearm related mortality in the USA surpassed all other developed countries. This study hypothesizes that injury patterns, weapon type, and mortality differ between suicide groups as opposed to homicide. The American College of Surgeons National Trauma Database was queried from January 2017 to December 2019. All firearm related injuries were included, and weapon type was abstracted. Differences between homicide and suicide groups by sex, age, race, and injury severity were compared using a Mann–Whitney test for numerical data and Fisher’s exact test for categorical data. The association between weapon type and mortality relative to suicide as opposed to homicide was assessed in Fisher’s exact tests. Significance was defined as p < 0.05. There were 100,031 homicide and 11,714 suicide subjects that met inclusion criteria. Homicides were mostly assault victims (97.6%), male (88%), African–American (62%), had less severe injury (mean (ISS) 12.07) and a median age of 20 years old (IQR: 14, 30, p < 0.01). Suicides were mostly male (83%), white (79%), had more severe injury (mean ISS 20.73), and a median age of 36 years old (IQR: 19, 54, p < 0.01). Suicide group had higher odds of head/neck (OR = 13.6) or face (OR = 5.7) injuries, with lower odds of injury to chest (OR = 0.55), abdominal or pelvic contents (OR = 0.25), extremities or pelvic girdle (OR = 0.15), or superficial soft tissue (OR = 0.32). Mortality rate was higher for suicide group (44.8%; 95% confidence interval (CI) 43.9%, 45.7%) compared to the homicide group (11.5%; 95% CI 11.3%, 11.7%). Suicide had higher mortality, more severe injuries, and more head/neck/facial injuries than homicide. Majority of suicides were with handguns.https://doi.org/10.1038/s41598-022-17280-2
spellingShingle Christopher W. Foote
Xuan-Lan Doan
Cheryl Vanier
Bianca Cruz
Babak Sarani
Carlos H. Palacio
Suicide versus homicide firearm injury patterns on trauma systems in a study of the National Trauma Data Bank (NTDB)
Scientific Reports
title Suicide versus homicide firearm injury patterns on trauma systems in a study of the National Trauma Data Bank (NTDB)
title_full Suicide versus homicide firearm injury patterns on trauma systems in a study of the National Trauma Data Bank (NTDB)
title_fullStr Suicide versus homicide firearm injury patterns on trauma systems in a study of the National Trauma Data Bank (NTDB)
title_full_unstemmed Suicide versus homicide firearm injury patterns on trauma systems in a study of the National Trauma Data Bank (NTDB)
title_short Suicide versus homicide firearm injury patterns on trauma systems in a study of the National Trauma Data Bank (NTDB)
title_sort suicide versus homicide firearm injury patterns on trauma systems in a study of the national trauma data bank ntdb
url https://doi.org/10.1038/s41598-022-17280-2
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