Comparative Analysis of Firearm Assault Injuries Due to Intimate Partner Violence and Non-Intimate Partner Violence in US Emergency Departments

Abstract

Intimate partner violence (IPV) and firearm violence threaten women’s health and safety in the United States. Despite the magnitude of female homicides and mass shootings resulting from IPV-related firearm incidents, research in this critical area remains limited. A retrospective review of prospectively collected data using the National Electronic Injury Surveillance System (NEISS) Firearm Injury Surveillance Study from 1993 through 2019 was performed. The study focused on firearm shooting injuries seen in US Emergency Departments (ED) during assaults, excluding unintentional injuries, suicide attempts, or law enforcement activity. The demographics and injury patterns of IPV and non-IPV groups were compared using statistical methods accounting for the weighted, stratified nature of the data. Over the 27-year period from 1993 through 2019, there were 60,730 ED visits for firearm injuries (limited to assaults when shot by the firearm for those 10 years or older) for an estimated 1,564,078 visits. IPV represented 0.9% (137,740 of the 1,564,078) estimated firearm-related injuries. IPV patients were more likely to be older (39.3 vs 27.7 years; p < 0.0001), female (59.0% vs 11.3%; p < 0.0001), white (62.5% vs 19.5%; p < 0.0001), occurred at home (67.1% vs 13.8%; p < 0.0001), sustained head and neck injuries (30.2% vs 15.0%; p = 0.0056) and with a higher mortality (12.3% vs 6.6%; p < 0.01) compared with non-IPV patients. Female IPV patients had more head and neck injuries (37.2% vs 20.2%; p = 0.03) than male patients. The average age of IPV patients when the perpetrator was an ex-boyfriend/girlfriend was lower (25.8 years) than when the perpetrator was a spouse (40.6 years) or ex-spouse (37.7 years) (p < 0.0001). One-third of the IPV patients were not married or did not report their marital status, supporting firearm restrictions for those already convicted of domestic violence offenses from a public health viewpoint. The study highlights the urgent need for interventions to reduce IPV-related firearm injuries, given the deliberate targeting of head and neck regions in female IPV patients and the high fatality rates observed in IPV patients presenting to ED.