Inner-city gunshot wounds–10 years on

In 1997, Injury published one of the first research papers to document the incidence and characteristics of civilian gunshot wounds in a UK urban environment. Since then there has been concern that firearm deaths and injuries have increased despite little published clinical evidence.

We carried out a retrospective survey ten years on from the initial study. All patients presenting to the Emergency Department (ED) of King's College Hospital with gunshot wounds from 1st January 2003 to 31st December 2004 were identified. Information regarding incidence, patient and injury characteristics and outcome was determined.

46 patients presented with firearm injuries. 44 were male and the average age was 24 years. The majority were from minority ethnic groups. 38/46 presented out of hours and the police were documented to be involved in 36 cases. All injuries were due to assault by low energy projectiles. Of the 32 patients admitted the mean length of stay was 12.4 days. The majority of injuries were to the musculo-skeletal system. Six patients died from their injuries–5 from head/neck or chest injuries and 1 from intra-abdominal injury.

There appears to be little increase in firearm injuries seen over this 10 year period at our hospital and predominately young, black males continue to be the victims. Most present out of hours,potentially placing considerable challenges on junior medical staff. Most wounds were to the musculoskeletal system perhaps reflecting the desire to maim rather than kill and the absence of high velocity injuries may reflect the UK's stringent gun control legislation. The importance of high quality clinical audit is necessary to effectively plan training, service provision and violence prevention efforts.

Despite public, political and media concerns that deaths and injuries caused by firearm shave increased dramatically, this study finds little change in incidence or characteristics of those injured and attending an urban ED over a ten year period.