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Guns and knives in New Mexico: patterns of penetrating trauma, 1978-1993
C Crandall1, L Olson, L Fullerton
1Center for Injury Prevention, Research, and Education, University of New Mexico, School of Medicine, Albuquerque, USA. ccrandall@salud.unm.edu
Objective:
To identify patterns of nonfatal and fatal penetrating trauma among children and adults in New Mexico using ED and medical examiner data.
Methods:
The authors retrospectively sampled in 5-year intervals all victims of penetrating trauma who presented to either the state Level-1 trauma center or the state medical examiner from a 16-year period (1978-1993). Rates of nonfatal and fatal firearm and stabbing injury were compared for children and adults.
Results:
Rates of nonfatal injury were similar (firearm, 34.3 per 100,000 person-years; stabbing, 35.1). However, rates of fatal injury were significantly different (firearm, 21.9; stabbing, 2.7; relative risk: 8.2; 95% confidence interval: 5.4, 12.5). From 1978 to 1993, nonfatal injury rates increased for children (p = 0.0043) and adults (p < 0.0001), while fatal penetrating injury remained constant. The increase in nonfatal injury in children resulted from increased firearm injury rates. In adults, both stabbing and firearm nonfatal injury rates increased.
Conclusions:
Nonfatal injury data suggest that nonfatal violence has increased; fatal injury data suggest that violent death rates have remained constant. Injury patterns vary by age, mechanism of trauma, and data source. These results suggest that ED and medical examiner data differ and that both are needed to guide injury prevention programs.
Insights
Nonfatal penetrating injuries, including firearm and stabbing incidents, have increased in New Mexico for both children and adults. However, fatal penetrating injury rates remained constant, highlighting differing trends in violence.
Area of Science:
- Public Health
- Trauma Surgery
- Forensic Pathology
Background:
- Penetrating trauma represents a significant public health concern, with varying incidence and outcomes across different demographics and injury mechanisms.
- Understanding injury patterns is crucial for developing targeted prevention strategies.
Purpose of the Study:
- To analyze trends in nonfatal and fatal penetrating trauma in New Mexico.
- To compare injury patterns between children and adults, considering firearm and stabbing incidents.
- To evaluate the utility of emergency department (ED) and medical examiner data in trauma surveillance.
Main Methods:
- Retrospective analysis of penetrating trauma cases in New Mexico from 1978 to 1993.
- Data sampled at 5-year intervals from the state's Level-1 trauma center and medical examiner.
- Comparison of nonfatal and fatal injury rates for firearm and stabbing injuries in children and adults.
Main Results:
- Nonfatal injury rates for firearm and stabbing were similar, but fatal firearm injuries were significantly higher than fatal stabbing injuries (RR: 8.2).
- Nonfatal injury rates increased significantly for both children and adults from 1978 to 1993.
- Fatal penetrating injury rates remained constant over the study period, while nonfatal injury rates rose, particularly firearm-related injuries in children.
Conclusions:
- Nonfatal violence, indicated by injury data, has increased, contrasting with stable violent death rates.
- Injury patterns differ based on age, trauma mechanism, and data source (ED vs. medical examiner).
- Both ED and medical examiner data are essential for comprehensive injury surveillance and effective prevention program development.
