Sex differences in the victim-offender relationship among patients with non-fatal firearm-related injuries

Wiebe, D.J. (2003). Sex differences in the perpetrator-victim relationship among emergency department patients presenting with nonfatal firearm-related injuries. Annals of Emergency Medicine, 42(3);405-412.


Study Objectives: I examine whether female and male emergency department (ED) patients are equally likely to have been nonfatally shot or struck with a gun by someone they know versus by a stranger.

Methods: This case-control study examined patient records from US hospital EDs from 1993 to 1999. The records of patients aged 15 years or older who presented with nonfatal firearm-related injuries were accessed from the National Electronic Injury Surveillance System. Patients were classified according to 2 firearm-related injury types (penetrating or nonpenetrating [eg, struck with gun] trauma) and 5 perpetrator types (injury inflicted by spouse or ex-spouse, other relative, friend or acquaintance, self, or stranger).

Results: Compared with male patients, female patients were 3.6 times (95% confidence interval [CI] 2.5 to 5.3) more likely to have been shot and 3.9 times (95% CI 1.6 to 9.4) more likely to have been struck with a gun wielded by a spouse or ex-spouse than by a stranger. Conversely, women were considerably less likely than men to have been struck with a gun or shot by another relative, to have been struck with a gun by a friend or acquaintance, or to have a gunshot injury that was self-inflicted.

Conclusion: The cause of firearm-related injuries varies by sex. Before releasing firearm-injury victims from the ED, health care providers should consider 2 important factors: (1) the patient’s relationship to the perpetrator, and (2) the availability and previous use of firearms in the victim’s home. This information may be helpful in formulating posttreatment plans to enhance the victim’s safety.