Fatal firearm injuries in Finland: a nationwide survey.
OBJECTIVE
Treatment of life-threatening firearm injuries represents major challenges to the involved medical staff. The aim of the study was to assess numbers, natures and injury patterns of fatal incidents by firearms in Finland over a 10-year period.


METHODS
Retrospective analysis of all firearm-related deaths during the 10-year period from January 1990 to December 1999. Death certificates were obtained and reviewed with detailed analysis of non-suicidal deaths.


RESULTS
Over the 10-year period 1990 to 1999, 452 individuals (equivalent to 1.8 cases per 100 000 person-years) died in Finland as a result of accidental or violent shooting. There were no significant changes in numbers of cases from year to year. The male-female ratio was 7:3. The mean age of the victims was 32 years. The shooting incident had been classified as an assault in 78% of cases. Its nature was unspecified in 13% of cases and clearly accidental in 9%. The predominant anatomical site of fatal injury following assault was the chest in 43%, the head in 42% and the abdomen in 8% of the cases. After accidental or unspecified nature shooting, the predominant site of injury was the head in 68%, followed by the chest in 16% and the abdomen in 10% of the cases. Most victims (86%) died at the scene of the shooting. Only 14% were alive at hospital admittance. Most hospitalised victims died within 24 hours of admission.


CONCLUSIONS
The annual incidence of fatal non-suicidal firearm injuries did not change significantly in Finland between 1990 and 1999. Victims of such injuries required only minimal hospital resources because in most cases they died at the scene of the shooting. The results of the study reported indicate that efforts to prevent fatal injuries from use of firearms or diminish their number should be focused mainly on prevention of firearm related assault.
Mäkitie
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I
Eastern Command HQ, Finnish Defence Forces, Mikkeli, Finland.
Pihlajamäki
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H
D000007:Abdominal Injuries / Q000401:mortality; D000328:Adult; D005260:Female; D005387:Finland / Q000453:epidemiology; D020197:Head Injuries, Penetrating / Q000401:mortality; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013898:Thoracic Injuries / Q000401:mortality; D014948:Wounds, Gunshot / Q000401:mortality*