1. Based on the 187 U.S. mass shooting events that occurred in 2019, non-trauma centers were more likely to be closer than trauma centers, which suggests a need for these facilities to be prepared for traumatic events in terms of both resources and staff.
Evidence Rating Level: 2 (Good)
Mass shootings have been rising in the past decade – a 300% increase over that period of time. Due to the ease with which large shooting events can overwhelm hospital resources, the placement and specialty areas of these hospitals is important. This retrospective study was concerned with the locations of Level 1 trauma centers (TCs) and non-trauma centers (NTCs) in relation to 2019 events because many patients are required to be transferred during these events, further risking their outcomes. Using the Gun Violence Archive for 2019 alone, 187 events occurred across 38 U.S. states, during which at least five or more injuries/deaths occurred by firearm. Case fatality rate was 23.8% (298 deaths) and 1,250 individuals were injured. At least one pediatric patient was involved in 54 of these events. NTCs were found to be closer to these shooting events (mean [SD] distance = 4.49 [4.34] miles) than both pediatric TCs (43.78 [82.90] miles) and adult TCs (13.14 [20.78]), all reaching significance at the 0.001 level. This study pointed out that the 23.8% mortality rate of these shootings exceeded that related to combat wounds (10%). The overall message is that it is more likely that an NTC will be the primary hospital for injured patients following these events. These facilities must be prepared for these types of events that formal TCs may otherwise be more equipped to handle due to sheer distance and expediency of care.
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