EPIDEMIOLOGY, MANNER AND OUTCOME OF FIREARM INJURIES IN NORTH INDIA: A ONE-YEAR PROSPECTIVE STUDY FROM A TERTIARY CARE CENTRE
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Keywords
Firearm injuries; Gunshot wounds; Homicidal violence; Trauma epidemiology; Illegal firearms; North India
Abstract
Firearm-related violence is a major cause of injury and death worldwide and poses significant medico-legal and public health challenges, particularly in low- and middle-income countries where illegal firearms are widely available. In India, firearm injuries show marked regional variation, and systematic hospital-based epidemiological data remain limited, especially from northern regions where country-made and unlicensed weapons are commonly used.
Objectives: To evaluate the epidemiology, manner of injury, weapon type, and clinical outcome of firearm injury cases presenting to a tertiary care centre in North India.
Methods: This was a prospective, observational, hospital-based study conducted in the Emergency Department of S. N. Medical College and Hospital, Agra, from March 2016 to February 2017. All patients presenting with firearm-related injuries and referred for medico-legal examination were included. A total of 124 cases were enrolled using universal sampling. Data on demographic characteristics, manner of injury (homicidal, suicidal, accidental), type of weapon used, number of shots, and clinical outcome were recorded using a structured proforma. Outcomes were categorized as conservative management, surgical intervention, or death. Data were analyzed using descriptive statistics and presented as frequencies and percentages.
Results: Of the 124 firearm injury cases, 112 (90.3%) were homicidal, 2 (1.6%) suicidal, and 10 (8.1%) accidental. Males constituted 114 cases (91.9%), and the most affected age group was 21–30 years (51.6%), followed by 31–40 years (24.2%). Shotguns (47.6%) and rifled firearms (45.2%) were used almost equally. A majority of patients required surgical intervention (78.5%), while 12 (9.7%) were managed conservatively. The case fatality rate was 11.8% (14 deaths).
Conclusion: Firearm injuries in North India predominantly involve young adult males and are largely homicidal, with a high burden of severe injuries requiring operative management. Both shotguns and rifled firearms contribute substantially to this violence, reflecting the widespread availability of illegal and locally manufactured weapons. These findings underscore the urgent need for stricter arms control, improved trauma care infrastructure, and targeted public health interventions to reduce firearm-related morbidity and mortality in the region.
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Dr. Manish Yadav
Assistant Professor, Department of Forensic Medicine & Toxicology, World College of Medical Sciences and Research, Jhajjar, Haryana, India.
Dr. Shalney Razdan
Professor, Department of Forensic Medicine & Toxicology, World College of Medical Sciences and Research, Jhajjar, Haryana, India.
Dr. Vikas Verma
Assistant Professor, Department of Forensic Medicine & Toxicology, World College of Medical Sciences and Research, Jhajjar, Haryana, India.
Dr. Jatin Prajapati
Senior Resident, Department of Community Medicine, World College of Medical Sciences and Research, Jhajjar, Haryana, India ( ORCID: https://orcid.org/0009-0004-7298-4499 )
