The Association of Firearm Caliber With Likelihood of Death From Gunshot Injury in Criminal Assaults
The Association of Firearm Caliber With Likelihood of Death From Gunshot Injury in Criminal Assaults
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DOI：
10.1001/jamanetworkopen.2018.0833
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发表时间：
2018-07-01
影响因子：
13.8
通讯作者：
Cook, Philip J.
中科院分区：
文献类型：
--
作者：
Braga, Anthony A.;Cook, Philip J.
重要性枪支政策的一个基本问题是在攻击中使用的武器类型是否影响死亡的可能性。目的确定在刑事攻击中造成的枪伤死亡的可能性是否与攻击者的枪支的力量有关，如其口径所示。作者从马萨诸塞州波士顿发生的袭击事件的警察调查档案中提取了枪击案件的多变量分析数据，2010年1月1日至2014年12月31日期间。这些数据在2017年10月1日至2018年2月18日期间进行了分析。在所有案件中，受害者在波士顿警察局认为是犯罪的情况下遭受了一处或多处枪伤。工作样本包括所有221起枪支凶杀案和从5年期间发生的1012起非致命案件中抽取的300起分层随机样本。七个非致命的情况下被省略，因为他们已经被错误classificated.EXPOSURES变异的主要来源是用于拍摄的victile.Main结局和措施的枪支口径的受害者是否死于枪伤（S）.RESULTS最终样本的511枪击受害者和幸存者（n = 220致命; n = 291非致命）主要是男性（n = 470 [92.2%]）。黑人（n = 413 [80.8%]）或西班牙裔（n = 69 [13.5%]）和年轻人（平均[SD]年龄，26.8 [9.4]岁）。警方调查确定了184起非致命案件（63.2%）和183起致命案件（83.2%）的枪支口径。367例患者按口径分为3组：小口径（.22，.25）。和.32），中（.38.. 380和9毫米），或大（.357马格南。.40、.44马格南、.45、10毫米和7.62 x 39毫米）。枪支口径与伤口数量、伤口位置、攻击情况或受害者特征没有系统性关联，这一点通过对每个变量簇的卡方检验和综合多项logit分析来证明。对死亡可能性的logit分析发现，与小口径病例相比，中口径病例的优势比为2.25（95%CI，1.37-3.70; P = 0.001），大口径病例的优势比为4.54（95%CI，2.37-8.70; P <0.001）。基于使用logit方程的模拟，用小口径枪支取代中口径和大口径枪支将使枪支凶杀案减少39.5%。结论和相关性枪支口径与犯罪袭击中枪伤死亡的可能性相关。用大口径手枪射击更致命，但并不比用小口径手枪射击更持久或准确。这一结论与枪支政策的设计直接相关。
IMPORTANCE A foundational issue in firearms policy has been whether the type of weapon used in an assault affects the likelihood of death.OBJECTIVE To determine whether the likelihood of death from gunshot wounds inflicted in criminal assaults is associated with the power of the assailant's firearm as indicated by its caliber.DESIGN, SETTING, AND PARTICIPANTS Cross-sectional study with multivariate analysis of data on shooting cases extracted by the authors from police investigation files for assaults that took place in Boston, Massachusetts, between January 1, 2010, and December 31, 2014. These data were analyzed between October 1, 2017, and February 18, 2018. In all cases the victim sustained 1 or more gunshot wounds in circumstances that the Boston Police Department deemed criminal. The working sample included all 221 gun homicides and a stratified random sample of 300 nonfatal cases drawn from the 1012 that occurred during the 5-year period. Seven nonfatal cases were omitted because they had been misclassified.EXPOSURES The primary source of variation was the caliber of the firearm used to shoot the victim.MAIN OUTCOMES AND MEASURES Whether the victim died from the gunshot wound(s).RESULTS The final sample of 511 gunshot victims and survivors (n = 220 fatal; n = 291 nonfatal) was predominantly male (n = 470 [92.2%]). black (n = 413 [80.8%]) or Hispanic (n = 69 [13.5%]), and young (mean [SD] age, 26.8 [9.4] years). Police investigations determined firearm caliber in 184 nonfatal cases (63.2%) and 183 fatal cases (83.2%). These 367 cases were divided into 3 groups by caliber: small (.22, .25. and .32), medium (.38..380, and 9 mm), or large (.357 magnum. .40, .44 magnum, .45, 10 mm, and 7.62 x 39 mm). Firearm caliber had no systematic association with the number of wounds, the location of wounds, circumstances of the assault, or victim characteristics, as demonstrated by chi(2) tests of each cluster of variables and by a comprehensive multinomial logit analysis. A logit analysis of the likelihood of death found that compared with small-caliber cases, medium caliber had an odds ratio of 2.25 (95% CI, 1.37-3.70; P = .001) and large caliber had an odds ratio of 4.54 (95% CI, 2.37-8.70; P < .001). Based on a simulation using the logit equation, replacing the medium- and large-caliber guns with small-caliber guns would have reduced gun homicides by 39.5%.CONCLUSIONS AND RELEVANCE Firearms caliber was associated with the likelihood of death from gunshot wounds in criminal assault. Shootings with larger-caliber handguns were more deadly but no more sustained or accurate than shootings with smaller-caliber handguns. This conclusion is of direct relevance to the design of gun policy.