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Abstract
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In 2022, the Centers for Disease Control and Prevention highlighted the alarming prevalence of firearm violence in the United States with 48 000 firearm-related deaths annually, equating to an average of 132 people succumbing to firearm-related injuries daily.1 In 2021, 54% of all firearm-related deaths in the United States were attributed to suicide, 43% were murders, and the remaining were accidental, law enforcement, or undetermined circumstances.2 More recently, the harrowing mass shooting in Maine that left 18 dead and 13 injured demonstrates the increasingly urgent need for more active physician participation in firearm injury prevention and advocacy, particularly from neurosurgeons.3
The concerning trend of escalating firearm injuries and violence continues to worsen. The Pew Research Center reports a 23% increase in firearm-related deaths, a 45% increase in firearm-related murders, and a 10% increase in firearm-related suicides since 2019.2 Firearm injuries and deaths disproportionately affect Black, American Indian, Alaska Native, and Hispanic populations—groups already marginalized within the health care system and neurosurgical/neurological care.1,4,5 In deaths among children, adolescents, and young adults, firearm-related injuries surpassed motor vehicle accidents as the most common cause of death from injury in 2017.6 These facts unequivocally demonstrate the severity of the violent epidemic that plagues our most vulnerable populations and the need for an urgent and collective effort to help prevent firearm injuries.
Neurosurgeons play a life-saving role in firearm-related traumatic brain injuries (TBIs). However, we cannot save them all, and these injuries are often deadly, even for those who can make it to the hospital. One study showed that half of individuals who were initially alive at the scene of a firearm-related TBI and were triaged to a level I or II trauma center died because of initial injury.7 The American Association of Neurological Surgeons (AANS) estimates that 12% of all TBIs in the country are attributable to firearms and that 90% of these are eventually fatal.8 Neurosurgeons are all too familiar with the complex management of these injuries, with primary injury to the brain tissue compounded by downstream effects of secondary injury, as well as possible associated cerebrovascular injuries, cerebrospinal fluid leakage problems, and other craniofacial or polytrauma issues.9-12 Many patients suffer from debilitating neurological deficits even after neurosurgical intervention.8,13
In 2019, physician leaders joined forces to address this urgent public health crisis with a strategic plan for reducing firearm injury, disability, and death, formulated by the American College of Surgeons, American College of Physicians, American College of Emergency Physicians, American Academy of Pediatrics, and the Council of Medical Specialty Societies.14 In 2021, neurosurgeons of the AANS and the Congress of Neurological Surgeons endorsed a 2021–2022 congressional appropriation of $60 million to the National Institutes of Health and Centers for Disease Control and Prevention for firearm injury prevention.15-17 A position statement on firearm injury prevention from the AANS/Congress of Neurological Surgeons recommends proper firearm use, storage, and ownership. This statement also suggests regulating firearm access for individuals with behavioral medical conditions and expanding access to mental health services. ...
Language: en |