Examining trends in gun violence injuries before and during the COVID-19 pandemic across six trauma centers

Constance McGraw; Stephanie Jarvis; Matthew Carrick; Mark Lieser; Robert M Madayag; Gina M Berg; Kaysie L Banton; David Hamilton; David Bar-Or

doi:10.1136/tsaco-2021-000801

Examining trends in gun violence injuries before and during the COVID-19 pandemic across six trauma centers

Trauma Surg Acute Care Open. 2022 Jan 10;7(1):e000801. doi: 10.1136/tsaco-2021-000801. eCollection 2022.

Authors

Constance McGraw¹, Stephanie Jarvis¹, Matthew Carrick², Mark Lieser³, Robert M Madayag⁴, Gina M Berg⁵, Kaysie L Banton⁶, David Hamilton⁷, David Bar-Or¹

Affiliations

¹ Trauma Research Department, Injury Outcomes Network, Englewood, Colorado, USA.
² Trauma Services Department, Medical City Plano, Plano, Texas, USA.
³ Trauma Services Department, Research Medical Center, Kansas City, Missouri, USA.
⁴ Trauma Services Department, St Anthony Hospital, Lakewood, Colorado, USA.
⁵ Trauma Services Department, Wesley Medical Center, Wichita, Kansas, USA.
⁶ Trauma Services Department, Swedish Medical Center, Englewood, Colorado, USA.
⁷ Trauma Services Department, Penrose-St Francis Health Services, Colorado Springs, Colorado, USA.

Abstract

Objectives: The onset of the national stay-at-home orders accompanied by a surge in firearm sales has elevated the concerns of clinicians and public health authorities. The purpose of this study was to examine the impact of the stay-at-home orders among gunshot wound (GSW) trauma admissions.

Methods: This was a retrospective cohort study at six level I trauma centers across four states. Patients admitted after the onset of COVID-19 restrictions (March 16, 2020-June 30, 2020) were compared with those admitted during the same period in 2019. We compared (1) rate of patients with GSW and (2) characteristics of patients with GSW, by period using Χ² tests or Fisher's exact tests, as appropriate.

Results: There were 6996 trauma admissions across the study period; 3707 (53%) in 2019 and 3289 (47%) in 2020. From 2019 to 2020, there was a significant increase in GSW admissions (4% vs. 6%, p=0.001); 4 weeks specifically had significant increases (March 16-March 23: 4%, April 1-April 8: 5%, April 9-April 16: 6%, and May 11-May 18: 5%). Of the 334 GSWs, there were significant increases in patients with mental illness (5% vs. 11%, p=0.03), alcohol use disorder (2% vs. 10%, p=0.003), substance use disorder (11% vs. 25%, p=0.001), and a significant decrease in mortality (14% vs. 7%, p=0.03) in 2020. No other significant differences between time periods were identified.

Conclusion: Our data suggest that trauma centers admitted significantly more patients with GSW following the national guidelines, including an increase in those with mental illness and substance use-related disorders. This could be attributable to the stay-at-home orders.

Level of evidence: Level III, retrospective study.

Keywords: COVID-19; firearms; gunshot; wounds.