Citation

Matthay ZA, Callcut RA, Kwok AM, Aarabi S, Forrester JD, Kornblith LZ. Ann. Surg. 2021; ePub(ePub): ePub.

Copyright

(Copyright © 2021, Lippincott Williams and Wilkins)

DOI

10.1097/SLA.0000000000005334

PMID

34913894

Abstract

OBJECTIVE: This study aimed to characterize changes in firearm injuries at five level 1 trauma centers in Northern California in the twelve months following the start of the COVID-19 pandemic compared to the preceding four years, accounting for regional variations and seasonal trends. SUMMARY AND BACKGROUND DATA: Increased firearm injuries have been reported during the early peaks of the COVID-19 pandemic despite shelter-in-place restrictions. However, these data are overwhelmingly from single center studies, during the initial phase of the pandemic prior to lifting of shelter-in-place restrictions, or do not account for seasonal trends.

METHODS: An interrupted time-series analysis (ITSA) of all firearm injuries presenting to five adult level 1 trauma centers in Northern California was performed (January 2016-February 2021). ITSA modeled the association of the onset of the COVID-19 pandemic (March 2020) with monthly firearm injuries using the ordinary least squares method, included month indicators to adjust for seasonality, and specified lags of up to 12 months to account for autocorrelation.

RESULTS: Prior to the start of COVID-19, firearm injuries averaged (±SD) of 86 (±16) and were decreasing by 0.5/month (p<0.01). The start of COVID-19 (March 2020) was associated with an alarming increase of 39 firearm injuries/month (p<0.01) followed by an ongoing rise of 3.5/month (p < 0.01). This resulted in an average of 130 (±26) firearm injuries/month during the COVID-19 period and included 8 of the 10 highest monthly firearm injury rates in the past five years.

CONCLUSIONS: These data highlight an alarming escalation in firearm injuries in the 12 months following the onset of the COVID-19 pandemic in Northern California. Additional studies and resources are needed to better understand and address this parallel public health crisis.

Language: en