• Veronica A Pear, Christopher D McCort, Nicole Kravitz-Wirtz, Aaron B Shev, Ali Rowhani-Rahbar, and Garen J Wintemute.
• Violence Prevention Research Program, Department of Emergency Medicine, University of California Davis School of Medicine, United States of America; University of California Firearm Violence Research Center, United States of America. Electronic address: vapear@ucdavis.edu.
• Prev Med. 2020 Oct 1; 139: 106198.

AbstractIndividuals with a firearm injury are at high risk of subsequent firearm victimization, but characteristics associated with sustaining recurrent firearm injuries are not well understood. In this retrospective cohort study, we sought to quantify the hazards of sustaining subsequent assaultive firearm injuries among people with an initial firearm assault injury and to identify characteristics associated with recurrent victimization. Using hospital discharge, emergency department, and mortality records, we identified and followed all individuals aged ≥15 years with a nonfatal firearm assault injury resulting in an emergency department visit or hospital admission in California, 2005-2013. We model transitions from one injury to the next and from injury to death, accounting for event history, covariates, and competing risks using multistate models. 29,156 people had an index nonfatal firearm assault injury. Among individuals with 1 such injury, 3.1% had additional nonfatal firearm assault injuries and 1.0% subsequently died from firearm homicide. Among individuals with 2+ nonfatal firearm assaults, 2.0% died from firearm homicide. The estimated transition probability for 1 to 2+ nonfatal injuries reached 10% by 8.5 years post-index injury. The rate of subsequent nonfatal firearm assault injury was highest among men (hazard ratio [HR]: 3.87; 95% confidence interval [CI]: 2.63-5.69) and Blacks (vs. whites) (HR: 2.69; 95% CI: 1.99-3.64). Identification of additional risk markers will require more detailed individual-level data; nonetheless, this study supports the generalizability of findings from smaller studies, provides broad guidance for allocating scarce resources, and suggests that interventions on root causes of violence disparities may have downstream effects on recurrence.Copyright © 2020 Elsevier Inc. All rights reserved.

5 keywords...

hide…