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J Emerg Med. 2013 Mar;44(3):585-91. doi: 10.1016/j.jemermed.2012.07.058. Epub 2012 Sep 17.

Gunshot victims at a major level I trauma center: a study of 343,866 emergency department visits.

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Vanderbilt University School of Medicine, Nashville, Tennessee, USA.



Disturbing trends regarding the sex, age, and race of gunshot victims have been reported in previous national studies; however, gunshot trends have not been well documented in individual cities in the southeastern United States.


1) Analyze trends in gunshot wounds, particularly the association between gunshot wounds and race, among victims presenting to a Level I Trauma Center in Middle Tennessee; 2) Compare specific characteristics of gunshot victims to the general Emergency Department (ED) population.


This is a retrospective cohort study of 343,866 ED visits from 2004 to 2009.


Compared to the general ED population, gunshot victims were more predominantly male (87.5% vs. 43.4%), black (57.6% vs. 29.5%), younger (47.8% under age 25 years vs. 31.6%), and demonstrated higher Medicaid enrollment (78.6% vs. 44.7%). The majority of black gunshot victims were aged 18-25 years (47.1%) and victims of assault (65.9%). Non-black gunshot victims suffered more unintentional (40.2% vs. 28.2%) and self-inflicted (9.1% vs. 0.4%) injuries and were more evenly distributed among ages 18-55 years. Black patients were 3.03 (95% confidence interval 2.93-3.14) times more likely to present to this ED for gunshot wounds than non-black patients, after controlling for age, sex, and insurance status (p < 0.001).


Our study demonstrates that black patients between 18 and 25 years of age presenting to this trauma center are more likely to be victims of gun violence than their non-black counterparts. Our study evaluates trends in gun violence in the Southeast, particularly in relation to race, age, and insurance status.

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