The online Merriam-Webster’s dictionary defines “rush hour” as a time during the day early in the morning or late in the afternoon when many people are driving to or from work—a period of the day when the demands, especially for traffic or a business, are at a peak.* From a trauma mechanism kinematics perspective, motor vehicle-related crashes that occur during a heavy rush hour often result in less severe injuries because the speed at which motor vehicles are traveling is often below the posted speed.
Highway shootings
Unfortunately, during the last year or so in at least one major city, a new mechanism of injury resulting in rush hour fatalities has surfaced—expressway shootings—and these events, unlike other motor vehicle-related injuries occurring at those peak traffic periods, often result in significant injuries.
Entering the search terms “highway shooting,” “expressway shooting,” or “interstate shooting” into a Web search engine will yield more than 500,000 results. Highway and expressway shootings have increased steadily over the last several years. In Chicago, IL, for example, the number of expressway shootings for 2015 more than doubled to 40 from the previous year’s total of 19.† As of June of this year, 21 such shootings had already occurred in Chicago.
It is my observation that, at least initially, roadway shootings typically occurred in the late hours of the night or early in the morning and resulted in the closure of all inbound or outbound lanes to allow for a crime scene investigation. The closure and chaos often allowed the perpetrator a clean getaway. More recently, several shootings have taken place in denser traffic times, including rush hours.
To examine the occurrence of cases involving highway shootings contained in the National Trauma Data Bank® (NTDB®) research dataset admission year 2014, medical records were searched using the International Classification of Diseases, Ninth Revision, Clinical Modification codes. Specifically searched were records that included the location of injury code (E-code) E849.5 (Street and Highway), which would include the subset of highway along with a mechanism of injury that involved a firearm. A total of 9,532 records were found, of which 6,773 records contained a discharge status, including 5,557 patients discharged to home, 516 to acute care/rehab, and 122 sent to skilled nursing facilities; 578 died. Of these patients, 91.4 percent were male, on average 28.1 years of age, and had an average hospital length of stay of 5.7 days, an intensive care unit length of stay of 11.9 days, an average injury severity score of 11.8, and were on the ventilator for an average of 5.8 days (see Figure 1).
Figure 1. Hospital discharge status
A growing problem
Chicago is not alone. This scenario has been playing out in other areas around the U.S., including Arizona, California, Colorado, Florida, Maryland, Michigan, Ohio, Pennsylvania, Texas, Virginia, and Wisconsin, to name a few. Some have been labeled as acts of domestic terrorism, others as the product of gang violence, road rage, and domestic violence. Whatever the reason or wherever you may travel, be aware of this potential hazard that could result in a deadly rush hour.
Throughout the year, we will be highlighting these data through brief reports that will be found monthly in the Bulletin. The NTDB Annual Report 2015 is available on the ACS website as a PDF file. In addition, information is available on our website about how to obtain NTDB data for more detailed study. If you are interested in submitting your trauma center’s data, contact Melanie L. Neal, Manager, NTDB, at mneal@facs.org.
Acknowledgment
Statistical support for this article was provided by Chrystal Caden-Price, Data Analyst, NTDB.
*Rush hour. 2016. Merriam-Webster.com. Available at: www.merriam-webster.com/dictionary/rush%20hour. Accessed July 2, 2016.
†Bradley B. Chicago-area expressway shootings more than doubled since last year. ABC 7 Chicago. Available at: abc7chicago.com/news/chicago-area-expressway-shootings-doubled-since-last-year/1182757/. Accessed July 2, 2016.
