Increased incidence and shift in the location of gunshot wound injuries in dogs and cats during the COVID-19 pandemic

Jared L. Crofts Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA

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Bridget Radtke Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA

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Nolan V. Chalifoux Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA

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Erica L. Reineke Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA

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Abstract

OBJECTIVE

To investigate the incidence and patterns of gunshot wound trauma in patients that were presented to an urban level 1 veterinary trauma center before and after the start of the coronavirus disease of 2019 (COVID-19) pandemic.

ANIMALS

24 dogs and 1 cat.

METHODS

Medical records were retrospectively reviewed for patients presenting with gunshot wound injuries between March 2018 and February 2020 (prepandemic) and March 2020 and February 2022 (pandemic). The total number of patients presented to the hospital during those same time periods was also obtained. Patient data were collected including species, breed, age, sex, location of injury, trauma score (if available), surgical procedures performed, length of hospitalization, and case outcome.

RESULTS

In the prepandemic period, 9 patients were presented for gunshot wound injuries, whereas there were 16 patients evaluated for gunshot wound injuries during the pandemic period. The total number of gunshot wound cases increased by 77.8% in the pandemic period. The total number of hospital patient visits, however, decreased by 12.2% in the pandemic period as compared to the prepandemic period: 65,168 versus 74,262 patients, respectively. Injuries were predominantly localized to the extremities (55%) in the prepandemic period versus maxillofacial (56%) in the pandemic period.

CLINICAL RELEVANCE

There was an increased number of gunshot wound injuries in companion animals presenting to an urban level 1 veterinary trauma center during the COVID-19 pandemic. A shift in the predominant location of injury was also identified during the pandemic period. This study highlights the ramifications that societal dynamics can have on animal health and welfare.

Abstract

OBJECTIVE

To investigate the incidence and patterns of gunshot wound trauma in patients that were presented to an urban level 1 veterinary trauma center before and after the start of the coronavirus disease of 2019 (COVID-19) pandemic.

ANIMALS

24 dogs and 1 cat.

METHODS

Medical records were retrospectively reviewed for patients presenting with gunshot wound injuries between March 2018 and February 2020 (prepandemic) and March 2020 and February 2022 (pandemic). The total number of patients presented to the hospital during those same time periods was also obtained. Patient data were collected including species, breed, age, sex, location of injury, trauma score (if available), surgical procedures performed, length of hospitalization, and case outcome.

RESULTS

In the prepandemic period, 9 patients were presented for gunshot wound injuries, whereas there were 16 patients evaluated for gunshot wound injuries during the pandemic period. The total number of gunshot wound cases increased by 77.8% in the pandemic period. The total number of hospital patient visits, however, decreased by 12.2% in the pandemic period as compared to the prepandemic period: 65,168 versus 74,262 patients, respectively. Injuries were predominantly localized to the extremities (55%) in the prepandemic period versus maxillofacial (56%) in the pandemic period.

CLINICAL RELEVANCE

There was an increased number of gunshot wound injuries in companion animals presenting to an urban level 1 veterinary trauma center during the COVID-19 pandemic. A shift in the predominant location of injury was also identified during the pandemic period. This study highlights the ramifications that societal dynamics can have on animal health and welfare.

Introduction

In response to the coronavirus disease of 2019 (COVID-19) pandemic, stay-at-home orders were implemented across the US in March 2020. Following these new guidelines, an increase in background checks and firearm sales was reported, with a concomitant rise in gun violence across major US cities.13 Numerous human trauma centers reported an increased number of individuals presenting with gunshot wounds after the start of the pandemic in comparison to prior years.47 Although these trends have been documented nationwide, the city of Philadelphia has been particularly impacted by the effects of increased violence and associated firearm injuries.810

Despite the multitude of information supporting higher rates of peripandemic gun violence and associated gunshot-related injuries, there have been no reports on the consequences that this increased violence may have on companion animals. The exact incidence of gunshot injuries affecting veterinary patients is not well described; however, it is estimated that projectile injuries represent 14% of reported animal cruelty cases11 and up to 2% of trauma cases12 in the US. According to more recent data from the American College of Veterinary Emergency and Critical Care Veterinary Committee on Trauma registry, ballistic injuries in dogs and cats constituted 0.44% of all trauma cases (109/24,845) between April 1, 2017, and December 31, 2019.13 These injuries result in high patient morbidity and mortality, expensive hospitalization and treatment costs, and considerable emotional toll for owners.1214

The objective of this study was to investigate the incidence and patterns of gunshot wound trauma in patients that were presented to an urban level 1 veterinary trauma center before and after the start of the COVID-19 pandemic. We hypothesized that the rise in violence and gunshot wound injuries reported in the human medical field following the start of the COVID-19 pandemic would correlate with an increased number of gunshot wound injuries in veterinary patients over the same time frame. To our knowledge, this was the first evaluation of the impact of pandemic-related violence on companion animal health and welfare.

Methods

A single-center retrospective analysis was performed of patients presenting to an urban academic level 1 veterinary trauma center for evaluation of gunshot wound injuries. Patients were compared between 2 admission time periods: March 2018 to February 2020 (prepandemic) and March 2020 to February 2022 (pandemic). The institutional record database was searched for such patients using the following keywords: “gunshot,” “gun shot,” “projectile,” “ballistic,” “gun,” “firearm,” and “bullet.” All juvenile and adult patients that were presented for evaluation or treatment of a gunshot wound injury during each time period were included in the study. Gunshot wound cases identified via the medical record search were cross-referenced with Veterinary Committee on Trauma registry entries to ensure that all pertinent cases were recorded. Patients with historical gunshot wound injuries that were presented to the hospital for other medical reasons and patients with gunshot injuries found incidentally during evaluation with no clinical significance were excluded from the study.

The selected dates were strategically chosen to allow comparisons of gunshot wound injuries in companion animals for the 2 years before and after the enactment of COVID-19 ordinances in the state of Pennsylvania in March 2020. A 2-year analysis period was considered appropriate, particularly for the pandemic evaluation, as social distancing guidelines and lingering effects of increased pandemic-related violence persisted through this time, even after the more stringent restrictions (ie, stay-at-home directives) were lifted.

Patient data were collected including species, breed, age, sex, location of injury, Animal Trauma Triage (ATT) and Modified Glasgow Coma Scale (MGCS) scores (if available), surgical procedures performed, length of hospitalization, and case outcome. Case outcome indicated survival to discharge or humane euthanasia, although no distinction was made between animals that were euthanized due to financial reasons and those euthanized due to severity of injury. Location of injury was categorized on the basis of the region of localization of associated wounds as reported in medical records, imaging studies, and surgery reports. The locations included the following: maxillofacial, cervical, thoracic, extremities (ie, forelimbs and hind limbs), vertebral/spinal, and abdominal. Injuries classified as thoracic or abdominal do not necessarily imply intracavitary penetration, as some injuries merely overlie the thorax or abdomen. Surgeries performed were classified into the following categories: wound exploration and debridement, oral surgery and dentistry, fracture repair, exploratory laparotomy, median sternotomy/lateral thoracotomy, and amputation. With regards to both location of injury and surgeries performed, the categories were not mutually exclusive, as 1 patient could have had a multitude of wounds that localized to different body parts and therefore required several different types of procedures.

The Shapiro-Wilk test was used to assess continuous variables for normality. Parametric variables were reported as the mean and SD, and nonparametric variables were reported as the median and range. The count and percentage (%) were used to report frequency data. The χ2 test was used to compare proportions of the dichotomous outcome variables when the cell counts in the 2 X 2 contingency table were > 5; otherwise, a Fisher exact test was used. For all comparisons, P < .05 was considered statistically significant. All statistical calculations were conducted using a commercial software package (Stata/IC version 16.1; StataCorp LLC).

Results

From March 2018 to February 2020 (prepandemic), 9 patients were presented for gunshot wound injuries, whereas 16 patients were evaluated for gunshot wound injuries from March 2020 to February 2022 (pandemic). The total number of gunshot wound cases increased by 77.8% between the prepandemic and pandemic periods, while the total number of hospital cases decreased by 12.2% over the same time frame, from 74,262 to 65,168, respectively. This equates to a prepandemic gunshot wound incidence of 0.01% (9/74,262) compared to a postpandemic gunshot wound incidence of 0.02% (16/65,168; P = .084).

Twenty-five animals were included in the study: 24 (96%) dogs and 1 (4%) cat. Of the 24 dogs, there were 10 (42%) pit bull-type dogs, 8 (33%) mixed-breed dogs, 2 (8%) Labrador Retrievers, and 1 each of various other breeds, including Boxer, Akita, Cane Corso, and Rottweiler. The only feline featured in this study was a domestic shorthair cat that was included within the pandemic period cohort of patients. The mean age of affected patients was 3.2 ± 2.0 years. Of the 25 animals, 17 (68%) were males and 8 (32%) were females. Six patients (6/9 [66%]) in the prepandemic period had ATT and MGCS scores recorded at admission compared to only 4 patients (4/16 [25%]) in the pandemic period.

Prepandemic: March 2018 to February 2020

The distribution of injuries was as follows: extremities (55%), thoracic (33%), vertebral/spinal (22%), abdominal (22%), maxillofacial (11%), and cervical (11%; Table 1). One dog was injured due to the accidental discharge of a firearm within the household, 2 patients were inadvertently wounded during altercations between their owners and other individuals, and the remainder of injuries were either unwitnessed or unspecified in the medical record. Among the patients with recorded trauma scores, the median ATT score was 8.5 (range, 3 to 10) and the median MGCS score was 17.5 (range, 14 to 18). Three patients were humanely euthanized, and 6 patients survived to discharge after receiving additional care. Among the survivors, 5 patients were admitted for hospitalization with a mean length of stay of 5.6 ± 5.2 days and 1 patient was treated on an outpatient basis. Three patients underwent surgery, with the following procedures performed: 2 patients required wound exploration and debridement, 2 patients required amputation (1 digit amputation and 1 left forelimb amputation, both due to comminuted fractures), and 1 patient required both a median sternotomy and exploratory laparotomy for bicavitary hemorrhage.

Table 1

Distribution of gunshot wound injuries in dogs and cats in the prepandemic (March 2018 to February 2020) and pandemic (March 2020 to February 2022) admission time periods.

Gunshotwound location Prepandemic Pandemic P value
Maxillofaciala 1/9 (11%) 9/16 (56%) .04
Cervical 1/9 (11%) 7/16 (43%) .182
Thoracic 3/9 (33%) 2/16 (12.5%) .312
Extremities 5/9 (55%) 4/16 (25%) .200
Vertebral/spinal 2/9 (22%) 1/16 (6%) .530
Abdominal 2/9 (22%) 0/16 (0%) .120

Percentages represent the proportion of total gunshot wound patients per admission time period with injuries to each specified location. Categories are not mutually exclusive, as patients could have had injuries to multiple locations.

aThe proportion of injuries within a location category is significantly (P < .05) different between the admission time periods.

Pandemic: March 2020 to February 2022

The distribution of injuries was as follows: maxillofacial (56%), cervical (43%), extremities (25%), thoracic (12.5%), vertebral/spinal (6%), and abdominal (0%; Table 1). One dog was inadvertently injured during an altercation between its owner and other individuals, 1 dog was wounded while attacking another dog, and the remainder of injuries were either unwitnessed or unspecified in the medical record. Among the patients with recorded trauma scores, the median ATT score was 4 (range, 2 to 7) and the median MGCS score was 16.5 (range, 15 to 18). Three patients were humanely euthanized, and 13 patients survived to discharge after receiving additional care. Among the survivors, 6 patients were admitted for hospitalization with a mean length of stay of 2.2 ± 1.2 days and 7 patients were treated on an outpatient basis. The single cat included in the study sustained injuries to the cervical and vertebral/spinal regions and was humanely euthanized after initial evaluation. Ten patients underwent surgery, with the following procedures performed: 6 patients required wound exploration and debridement, 3 patients required oral surgery and dentistry procedures (ie, palatal repair, teeth extraction, and mandibulectomy), 1 patient underwent an open reduction and internal fixation fracture repair, and 1 patient required amputation of a disarticulated distal phalanx.

Discussion

This study demonstrated an increased incidence of gunshot wound injuries in companion animals presenting to an urban level 1 veterinary trauma center during the COVID-19 pandemic. A shift in the predominant location of injury was also identified. Injuries to the extremities and thorax were more common prior to the pandemic, compared to a predominance of maxillofacial and cervical injuries after the start of the pandemic. In particular, there was a statistically significant increase in the number of maxillofacial injuries during the pandemic period (P = .04). This finding may reflect more targeted acts of violence during the pandemic, as maxillofacial and cervical wounds typically result from point-blank or close-range aggression with the animal facing the firearm.14 There is a possibility that this injury distribution may be related to increased reports of domestic violence and assaults during stay-at-home orders, as animals may come to the defense of owners during altercations and suffer resultant injuries. Alternatively, animals may simply be inadvertent bystanders caught in the crossfires of violent acts centered around households where individuals spent more time during stay-at-home directives and the subsequent era of social distancing guidelines.15 Ultimately, in most cases, the specific details regarding how the gunshot injuries occurred could not be determined due to the retrospective nature of this study and because most injuries (80%) were either unwitnessed or had an unspecified history in the medical record. In the author’s experience, it is common for limited information to be given to the veterinarian regarding the circumstances surrounding the gunshot injury. This is often due to individuals such as police, family members, or rescue organizations seeking care for the animal initially or, in other cases, could be due to concern on the part of the pet owner for potential legal implications.

Similar to our prepandemic findings, 2 of the most recent studies12,14 investigating gunshot injuries in dogs and cats reported the extremities and thorax as the most common locations affected. In a 1997 paper14 evaluating 84 cases of gunshot wounds in dogs and cats, approximately 43% of injuries were sustained on the limbs and 26% involved the thorax. Head and neck injuries were the next most common, representing 16% of all injuries, with the abdomen and vertebral column least affected at 11% and 3%, respectively. A 2014 study12 consisting of 37 cases of gunshot wounds in dogs and cats found that injuries to the forelimbs and hind limbs comprised approximately 32% of cases, while thoracic injuries comprised 22% of the cases. Injuries to the head and neck each comprised roughly 16% of the included cases, and abdominal injuries occurred in 14% of cases. Young male dogs were overrepresented in both studies,12,14 as was also true in our study. The overall survival rate in our study was 76%, which is also comparable to that reported in other studies,12,14 suggesting that animals with gunshot injuries can achieve good outcomes. Whereas dog breeds traditionally considered working breeds were overrepresented in one of these previous studies,12 pit bull-type dogs and mixed-breed dogs comprised the majority of patients in the present study. This was likely attributed to regional differences in breed popularity and preference, as well as the fact that hunting, which accounted for numerous injuries in the aforementioned study,12 is less common in the urban environment where our institution is located.

Although other studies have described characteristics and treatment of gunshot wounds in dogs and cats, this was the first study to analyze the patterns of such injuries within the context of COVID-19 pandemic–related violence. This is particularly important because the correlation between the pandemic and increased violence has been well-documented in people.1 A dramatic increase in the number of firearm background checks was reported by the Federal Bureau of Investigation during the initial stages of the pandemic,2 and the Brookings Institute estimates that nearly 3 million more firearms were purchased during the pandemic compared to the same period in 2019.7 The Pennsylvania Instant Check System processed 1,445,910 background check requests in 2020, making it the highest-volume year since its inception in 1998. In 2020, a total of 1,141,413 firearms were reported in Pennsylvania as purchased or transferred, compared to 766,204 firearms in 2019.16 Increases in crime were reported nationwide concurrently with this rise in firearm sales, and gun violence reached new heights in Philadelphia following implementation of pandemic ordinances. One study10 documented a 62.4% increase in gunshot wounds in Philadelphia during the early stages of the pandemic (March 16, 2020, to May 30, 2020) when compared to previous years. Similarly, reports of shootings throughout the city increased during a similar time frame, with data showing an approximately 7% increase in shooting victims during the period of April 1, 2020, to April 15, 2020, compared to the same time of the prior year.17 Given that our hospital is located in Philadelphia, a busy urban setting in which changes in patterns of violence associated with the COVID-19 pandemic are particularly evident, we believe that the increased number of gunshot wound injuries reported in this study are reflective of the ramifications that such violence can have on companion animals.

In conjunction with reports of intensifying violence across the country, numerous human hospitals noted an increase in admissions for gunshot wound injuries. One study8 investigating admissions to all trauma centers in Pennsylvania found an increased incidence of gunshot wound injuries during the pandemic despite a decrease in total trauma admissions, with a > 4-fold increase in penetrating injuries in the city of Philadelphia. A review of patients presenting to a level 1 trauma center in Philadelphia demonstrated a greater proportion of intentional violent injury, especially from firearms, following enactment of stay-at-home orders.10 Similarly, trauma centers across numerous other states documented a significant rise in gunshot wound victims following the onset of the COVID-19 pandemic.4,6,7 Interestingly, while most studies in the human literature do not compare localization of gunshot injuries before and after the pandemic, 1 study5 reviewing patients in the trauma registry at an Atlanta hospital found an increased incidence of patients sustaining gunshot wounds to the head and neck during the COVID-19 pandemic, although no explanation was proposed to account for this phenomenon. This suggests that our findings of both an increased incidence of gunshot wounds and a shift in the predominant location of gunshot injuries sustained in companion animals during the COVID-19 pandemic parallel patterns observed in some human healthcare settings. Accordingly, by monitoring trends reported in human medicine, particularly during unprecedented circumstances such as the COVID-19 pandemic, veterinarians may better predict and thus prepare for similar problems affecting their patient population.

There were several limitations of this study. This was a retrospective review and thus was subjected to bias, confounding variables, missing data, and other weaknesses common to this study design. For example, trauma scoring (ATT and MGCS) was not available for most animals included in the study, precluding an evaluation of injury severity between patients in the 2 admission time periods. Trauma scores may not have been recorded for a variety of reasons, including an unprecedented increase in emergency caseload at the start of the pandemic, shortage of personnel for trauma registry data entry due to changes in hospital staffing and responsibilities, or lack of house officer knowledge of the requirement to document trauma scores.

Additionally, the results published in this study were collected from a single veterinary trauma center in Philadelphia and therefore may not be applicable to the entire veterinary community. It is also possible that there is a cohort of gunshot injury patients that were treated by other area hospitals without subsequent referral or that were not presented for care if the animal died at home or the injury was perceived to be minor. Therefore, the true incidence of gunshot injuries may be greater than what is reported in this study. Although the increased incidence of companion animal gunshot injuries in this study were attributed to changes in violence linked to the COVID-19 pandemic, the higher number of cases may have been driven by unrelated factors. Lastly, and perhaps most importantly, our study featured a small sample size and accordingly lacked sufficient power to demonstrate a statistically significant difference between prepandemic and pandemic gunshot wound injuries. A follow-up study evaluating cases from multiple institutions could be considered to better characterize such patterns in gunshot-related injuries. Nevertheless, we believe that the current study identifies findings relevant to our patient population and sheds light on how societal dynamics can affect animal health and welfare.

Acknowledgments

None reported.

Disclosures

The authors have nothing to disclose. No AI-assisted technologies were used in the generation of this manuscript.

Funding

The authors have nothing to disclose.

References

  • 1.

    Sutherland M, McKenney M, Elkbuli A. Gun violence during COVID-19 pandemic: paradoxical trends in New York City, Chicago, Los Angeles and Baltimore. Am J Emerg Med. 2021;39:225-226. doi:10.1016/j.ajem.2020.05.006

    • Search Google Scholar
    • Export Citation
  • 2.

    NICS firearm background checks: month/year. Federal Bureau of Investigation. Updated May 2023. Accessed June 4, 2023. https://www.fbi.gov/file-repository/nics_firearm_checks_-_month_year.pdf/view

    • Search Google Scholar
    • Export Citation
  • 3.

    Ssentongo P, Fronterre C, Ssentongo AE, et al. Gun violence incidence during the COVID-19 pandemic is higher than before the pandemic in the United States. Sci Rep. 2021;11(1):20654. doi:10.1038/s41598-021-98813-z

    • Search Google Scholar
    • Export Citation
  • 4.

    Padubidri AA, Rushing A, Ochenjele G, et al. Increase in gunshot wounds at a level 1 trauma center following the COVID19 pandemic. OTA Int. 2021;4(4):e159. doi:10.1097/OI9.0000000000000159

    • Search Google Scholar
    • Export Citation
  • 5.

    Amin D, Manhan A, Smith R, Roser SM, Abramowicz S. Incidence of gunshot wounds to head and neck increased during COVID-19 pandemic. J Oral Maxillofac Surg. 2021;79(10):e15. doi:10.1016/j.joms.2021.08.026

    • Search Google Scholar
    • Export Citation
  • 6.

    Yeates EO, Grigorian A, Barrios C, et al. Changes in traumatic mechanisms of injury in Southern California related to COVID-19: penetrating trauma as a second pandemic. J Trauma Acute Care Surg. 2021;90(4):714-721. doi:10.1097/TA.0000000000003068

    • Search Google Scholar
    • Export Citation
  • 7.

    McGraw C, Jarvis S, Carrick M, et al. Examining trends in gun violence injuries before and during the COVID-19 pandemic across six trauma centers. Trauma Surg Acute Care Open. 2022;7(1):e000801. doi:10.1136/tsaco-2021-000801

    • Search Google Scholar
    • Export Citation
  • 8.

    Ratnasekera AM, Seng SS, Jacovides CL, et al. Rising incidence of interpersonal violence in Pennsylvania during COVID-19 stay-at home order. Surgery. 2022;171(2):533-540. doi:10.1016/j.surg.2021.06.024

    • Search Google Scholar
    • Export Citation
  • 9.

    Afif IN, Gobaud AN, Morrison CN, et al. The changing epidemiology of interpersonal firearm violence during the COVID-19 pandemic in Philadelphia, PA. Prev Med. 2022;158:107020. doi:10.1016/j.ypmed.2022.107020

    • Search Google Scholar
    • Export Citation
  • 10.

    Abdallah HO, Zhao C, Kaufman E, et al. Increased firearm injury during the COVID-19 pandemic: a hidden urban burden. J Am Coll Surg. 2021;232(2):159-168.e3. doi:10.1016/j.jamcollsurg.2020.09.028

    • Search Google Scholar
    • Export Citation
  • 11.

    Bradley-Siemens N, Brower AI. Veterinary forensics: firearms and investigation of projectile injury. Vet Pathol. 2016;53(5):988-1000. doi:10.1177/0300985816653170

    • Search Google Scholar
    • Export Citation
  • 12.

    Olsen LE, Streeter EM, DeCook RR. Review of gunshot injuries in cats and dogs and utility of a triage scoring system to predict short-term outcome: 37 cases (2003-2008). J Am Vet Med Assoc. 2014;245(8):923-929. doi:10.2460/javma.245.8.923

    • Search Google Scholar
    • Export Citation
  • 13.

    Hall KE, Rutten JI, Baird TN, et al. ACVECC-Veterinary Committee on Trauma registry report 2017-2019. J Vet Emerg Crit Care (San Antonio). 2023;33(3):289-297. doi:10.1111/vec.13295

    • Search Google Scholar
    • Export Citation
  • 14.

    Fullington RJ, Otto CM. Characteristics and management of gunshot wounds in dogs and cats: 84 cases (1986-1995). J Am Vet Med Assoc. 1997;210(5):658-662.

    • Search Google Scholar
    • Export Citation
  • 15.

    Rhodes HX, Petersen K, Lunsford L, Biswas S. COVID-19 resilience for survival: occurrence of domestic violence during lockdown at a rural American College of Surgeons verified level one trauma center. Cureus. 2020;12(8):e10059. doi:10.7759/cureus.10059

    • Search Google Scholar
    • Export Citation
  • 16.

    Pennsylvania State Police 2020 firearms annual report. Commonwealth of Pennsylvania. Updated March 2022. Accessed July 14, 2023. https://www.psp.pa.gov/firearms-information/Firearms%20Annual%20report/Pennsylvania_State_Police_2021_Firearms_Annual_Report.pdf

    • Search Google Scholar
    • Export Citation
  • 17.

    Boserup B, McKenney M, Elkbuli A. Alarming trends in US domestic violence during the COVID-19 pandemic. Am J Emerg Med. 2020;38(12):2753-2755. doi:10.1016/j.ajem.2020.04.077

    • Search Google Scholar
    • Export Citation
  • 1.

    Sutherland M, McKenney M, Elkbuli A. Gun violence during COVID-19 pandemic: paradoxical trends in New York City, Chicago, Los Angeles and Baltimore. Am J Emerg Med. 2021;39:225-226. doi:10.1016/j.ajem.2020.05.006

    • Search Google Scholar
    • Export Citation
  • 2.

    NICS firearm background checks: month/year. Federal Bureau of Investigation. Updated May 2023. Accessed June 4, 2023. https://www.fbi.gov/file-repository/nics_firearm_checks_-_month_year.pdf/view

    • Search Google Scholar
    • Export Citation
  • 3.

    Ssentongo P, Fronterre C, Ssentongo AE, et al. Gun violence incidence during the COVID-19 pandemic is higher than before the pandemic in the United States. Sci Rep. 2021;11(1):20654. doi:10.1038/s41598-021-98813-z

    • Search Google Scholar
    • Export Citation
  • 4.

    Padubidri AA, Rushing A, Ochenjele G, et al. Increase in gunshot wounds at a level 1 trauma center following the COVID19 pandemic. OTA Int. 2021;4(4):e159. doi:10.1097/OI9.0000000000000159

    • Search Google Scholar
    • Export Citation
  • 5.

    Amin D, Manhan A, Smith R, Roser SM, Abramowicz S. Incidence of gunshot wounds to head and neck increased during COVID-19 pandemic. J Oral Maxillofac Surg. 2021;79(10):e15. doi:10.1016/j.joms.2021.08.026

    • Search Google Scholar
    • Export Citation
  • 6.

    Yeates EO, Grigorian A, Barrios C, et al. Changes in traumatic mechanisms of injury in Southern California related to COVID-19: penetrating trauma as a second pandemic. J Trauma Acute Care Surg. 2021;90(4):714-721. doi:10.1097/TA.0000000000003068

    • Search Google Scholar
    • Export Citation
  • 7.

    McGraw C, Jarvis S, Carrick M, et al. Examining trends in gun violence injuries before and during the COVID-19 pandemic across six trauma centers. Trauma Surg Acute Care Open. 2022;7(1):e000801. doi:10.1136/tsaco-2021-000801

    • Search Google Scholar
    • Export Citation
  • 8.

    Ratnasekera AM, Seng SS, Jacovides CL, et al. Rising incidence of interpersonal violence in Pennsylvania during COVID-19 stay-at home order. Surgery. 2022;171(2):533-540. doi:10.1016/j.surg.2021.06.024

    • Search Google Scholar
    • Export Citation
  • 9.

    Afif IN, Gobaud AN, Morrison CN, et al. The changing epidemiology of interpersonal firearm violence during the COVID-19 pandemic in Philadelphia, PA. Prev Med. 2022;158:107020. doi:10.1016/j.ypmed.2022.107020

    • Search Google Scholar
    • Export Citation
  • 10.

    Abdallah HO, Zhao C, Kaufman E, et al. Increased firearm injury during the COVID-19 pandemic: a hidden urban burden. J Am Coll Surg. 2021;232(2):159-168.e3. doi:10.1016/j.jamcollsurg.2020.09.028

    • Search Google Scholar
    • Export Citation
  • 11.

    Bradley-Siemens N, Brower AI. Veterinary forensics: firearms and investigation of projectile injury. Vet Pathol. 2016;53(5):988-1000. doi:10.1177/0300985816653170

    • Search Google Scholar
    • Export Citation
  • 12.

    Olsen LE, Streeter EM, DeCook RR. Review of gunshot injuries in cats and dogs and utility of a triage scoring system to predict short-term outcome: 37 cases (2003-2008). J Am Vet Med Assoc. 2014;245(8):923-929. doi:10.2460/javma.245.8.923

    • Search Google Scholar
    • Export Citation
  • 13.

    Hall KE, Rutten JI, Baird TN, et al. ACVECC-Veterinary Committee on Trauma registry report 2017-2019. J Vet Emerg Crit Care (San Antonio). 2023;33(3):289-297. doi:10.1111/vec.13295

    • Search Google Scholar
    • Export Citation
  • 14.

    Fullington RJ, Otto CM. Characteristics and management of gunshot wounds in dogs and cats: 84 cases (1986-1995). J Am Vet Med Assoc. 1997;210(5):658-662.

    • Search Google Scholar
    • Export Citation
  • 15.

    Rhodes HX, Petersen K, Lunsford L, Biswas S. COVID-19 resilience for survival: occurrence of domestic violence during lockdown at a rural American College of Surgeons verified level one trauma center. Cureus. 2020;12(8):e10059. doi:10.7759/cureus.10059

    • Search Google Scholar
    • Export Citation
  • 16.

    Pennsylvania State Police 2020 firearms annual report. Commonwealth of Pennsylvania. Updated March 2022. Accessed July 14, 2023. https://www.psp.pa.gov/firearms-information/Firearms%20Annual%20report/Pennsylvania_State_Police_2021_Firearms_Annual_Report.pdf

    • Search Google Scholar
    • Export Citation
  • 17.

    Boserup B, McKenney M, Elkbuli A. Alarming trends in US domestic violence during the COVID-19 pandemic. Am J Emerg Med. 2020;38(12):2753-2755. doi:10.1016/j.ajem.2020.04.077

    • Search Google Scholar
    • Export Citation

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