Prevalence of Weapons in the Health Care Setting: A Systematic Review and Meta-Analysis

This study aimed to systematicically evaluate and quantify the prevalence of weapons in the health care setting. A systematic search of MEDLINE, Embase, Scopus, Web of Science, CINAHL, and EBSCO MegaFILE was performed from inception to January 12, 2024. The primary outcome was the prevalence of weapons in the health care setting on patients and/or visitors. Prevalence was pooled across studies and estimated using a random effects model. Subgroup analyses were done based on types of weapons, characteristics of weapon carriers, weapons screening/detection technology, and screened population characteristics. A total of 14 observational studies were included. All studies were from the United States and were published between 1984 and 2023. Weapons prevalence ranged from 0.4% to 26.3% among populations screened in the included studies. The overall pooled weapons prevalence was 4.0% (95% CI, 2.0%-7.8%). Most weapons were bladed (3.8%; 95% CI, 1.5%-8.9%), followed by other weapons (0.6%; 95% CI, 0.3%-1.3%), and firearms (0.1%; 95% CI, 0.02%-0.5%; P<.01). Weapons prevalence was 2.0% (95% CI, 0.7%-5.8%) among individuals entering the hospital setting, compared with 1.6% (95% CI, 0.7%-3.4%) of individuals entering the emergency department and highest (24.3%; 95% CI, 21.6%-27.2%) when major trauma patients were hand-searched. Prevalence was higher in males than that in females (11.1% vs 3.1%; P=.01). Weapons should be expected on individuals presenting to hospitals in the United States; however, prevalence varied widely based on the setting, type of patients, and detection method.