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The Unaddressed Imperative

Rosalyn P. Sterling-Scott, MD; Alexander Kelter, MD; Chukwudi Onwuachi-Saunders, MD, MPH; Kenneth Menchion, MD; Jeffrey R. Wilson, PhD; Brenda Allmond, RN; Arthur W. Fleming, MD

Arch Surg. 1993;128(6):663-668.

Abstract
Objective
To describe the trends in firearm fatalities in California between 1987 and 1991 and the 153 firearm injuries in girls and women treated at the King/Drew Medical Center, Los Angeles, Calif, from September 1, 1991, to December 31, 1992.

Design
Retrospective study.

Setting
The study was conducted at the King/Drew Medical Center, a university-based county hospital, one of the major trauma centers in Los Angeles.

Patients
At the King/Drew Medical Center, 32 patients (21%) required at least one major procedure. Of the 16 patients who died, 14 (88%) died in the emergency department of wounds to the head (six patients), chest (five patients), and abdomen (three patients). The odds ratio of dying if injured in the head, face, or neck was 2.23, and in the abdomen, 1.0. Surgeons rarely probe for the underlying cause of injury.

Main Outcome
The outcome has been a 2.28-fold increase in deaths in girls and women aged 10 to 19 years.

Results
Much of the violence against girls and women is perpetrated by those known to them.

Conclusion
Firearms are the most frequently used weapon in female homicides. Firearm fatalities in women represent a significant problem among all ethnic groups. Trauma centers must take the lead in the collection of meaningful data to implement effective gender- and ethnic-specific violence prevention strategies.

(Arch Surg. 1993;128:663-668)

Author Affiliations
From the Department of Surgery, Charles R. Drew University of Medicine and Science, Los Angeles, Calif (Drs Sterling-Scott, Menchion, Wilson, and Fleming and Ms Allmond); Emergency Preparedness and Injury Control Program, California Department of Health Services, Sacramento (Dr Kelter); and the Philadelphia (Pa) Department of Public Health (Dr Onwuachi-Saunders).

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