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Penetrating trauma in Ontario emergency departments: a population-based study

Published online by Cambridge University Press:  21 May 2015

Alison K. Macpherson  and
Michael J. Schull
Alison K. Macpherson*
Affiliation:
School of Kinesiology and Health Science, York University, Toronto, Ont. Institute for Clinical Evaluative Sciences, Toronto, Ont.
Michael J. Schull
Affiliation:
Institute for Clinical Evaluative Sciences, Toronto, Ont. Division of Emergency Medicine, Department of Medicine, Sunnybrook and Women's College Health Science Centre, Toronto, Ont., and Faculty of Medicine, University of Toronto, Toronto, Ont.
*
School of Kinesiology and Health Science, York University, 4700 Keele St., Toronto ON M3J 1P3

Abstract

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Background:

There is a paucity of population-based research on health service utilization related to penetrating trauma in Canada, even though such trauma can result in serious injury or death, and gunshot wounds have been labelled the “the new public health issue.” Complete epidemiologic data, including emergency department (ED) visits and hospitalizations, for penetrating trauma is not available. The objective of this paper is to describe the epidemiology of ED visits for firearm-related and knife-related penetrating trauma in one Canadian province.

Methods:

All EDs in the province of Ontario (pop. approx. 12 400 000 at the time of the study) submit data on ED visits to the National Ambulatory Care Reporting System. This database includes patients' demographic information (i.e., age, sex and geographic area of residence), the reason for the visit, disposition (i.e., admitted to hospital or sent home), and other diagnostic information. For visits related to injuries, the cause of injury is also reported (e-codes according to the Canadian Enhancement to the International Statistical Classification of Diseases and Related Health Problems, 10th rev [ICD-10-CA]). All patients seen in Ontario EDs for an injury related to a firearm, knife, or sharp object, were included in our study.

Results:

Of the 1.2 million ED visits in 2002-03 for trauma in Ontario, 40 240 (3.4%) patients were treated for injuries relating to penetrating trauma. Most patients were male, and most were 15–24 years of age. Penetrating trauma was frequently a result of knives or sharp objects (39 654 visits or 98.5%); only 1.5% (n = 586) of these injuries were caused by firearms. Of those hospitalized, 151 were related to firearms and 1455 were related to knives/ sharp objects.

Conclusions:

Analyzing administrative data provides an estimate of the impact of penetrating trauma on a population, thereby providing prevention programs with data upon which to design their strategies. Evidence-based prevention strategies are needed to reduce the burden of penetrating trauma. Monitoring ED and hospitalization data over time will help to assess trends and provide evidence for the effectiveness of such strategies.

Keywords

injurytraumafirearmssharp objects
Type
Original Research • Recherche originale
Information
Canadian Journal of Emergency Medicine , Volume 9 , Issue 1 , January 2007 , pp. 16 - 20
Copyright
Copyright © Canadian Association of Emergency Physicians 2007

References

1.Richmond, TS, Cheney, R, Schwab, CW.The global burden of non-conflict related firearm mortality. Inj Prev 2005;11:348–52.CrossRefGoogle ScholarPubMed
2.Price, JH, Thompson, AJ, Dake, JA.Factors associated with state variations in homicide, suicide and unintentional firearm deaths. J Comm Health 2004;29:271–83.Google Scholar
3.Hootman, JM, Annest, JL, Mercy, JA, et al. National estimates of non-fatal firearm related injuries other than gunshot wounds. Inj Prev 2000;6:268–74.Google Scholar
4.Crandall, C, Olson, L, Fullerton, L, et al. Guns and knives in New Mexico: patterns of penetrating trauma, 1978–1993. Acad Emerg Med 1997;4:263–7.Google Scholar
5.Sloan, JH, Kellermann, AL, Reay, DT, et al. Handgun regulations, crime, assaults, and homicide. A tale of two cities. N Engl J Med 1988;319:1256–62.CrossRefGoogle ScholarPubMed
6.Miller, TR, Cohen, MA.Costs of gunshot and cut/stab wounds in the United States, with some Canadian comparisons. Accid Anal Prev 1997;29(3):329–41.CrossRefGoogle ScholarPubMed
7.Mackay, B.Gunshot wounds: the new public health issue. CMAJ 2004;170:780.CrossRefGoogle ScholarPubMed
8.Chapdelaine, A, Samson, E, Kimberlye, MD, et al. Firearm-related injuries in Canada: issues for prevention. CMAJ 1991;145:1217–23.Google Scholar
9.Chapdelaine, A, Maurice, P.Firearms injury prevention and gun control in Canada. CMAJ 1996;155:1285–8.Google Scholar
10.Wilkins, K.Deaths involving firearms. Health Rep 2005;16(4):37–43.Google ScholarPubMed
11.Miller, T.Costs associated with gunshots in Canada in 1991. CMAJ 1995;153:1261–8.Google Scholar
12.Beveridge, R, Clarke, B, Janes, L, et al. Canadian Emergency Department Triage and Acuity Scale: implementation guidelines. Can J Emerg Med 1999;1(3 suppl). Online version available at: www.caep.ca (accessed 21 Nov 2006).Google Scholar
13.Statistics Canada. 2001 Census of Canada. Available at: www.statcan.ca (accessed 21 Nov 2006).Google Scholar
14.Weapon Related Injury Surveillance System (WRISS) in Massachusetts. Weapon injury data: weapon injuries to Massachusetts residents, 1994–2001. 2003. Available at: www.state.ma.us /dph/bhsre/isp/isp.htm (accessed Sept 2006).Google Scholar
15.Wong, K, Petchell, J.Severe trauma caused by stabbing and firearms in metropolitan Sydney, New South Wales, Australia. ANZ J Surg 2005;75:225–30.CrossRefGoogle ScholarPubMed