Go to content

Guns and knives responsible for over 40,000 trauma visits to Emergency Departments


A new study from the Institute for Clinical Evaluative Sciences (ICES) shows that injuries from guns and knives account for over three per cent, or more than 40,000, of the 1.2 million emergency department (ED) visits for trauma in Ontario.

“Despite the costs to victims, their families and the healthcare system, and the fact that many of these injuries can be prevented, there has been little research regarding ED visits for guns and knives,” said Dr. Alison Macpherson, ICES adjunct scientist and lead author of the study.

“Gaining an understanding of the factors behind and magnitude of health services use for these sorts of injuries in Canada is an important step in developing prevention strategies.”

To provide more information on this issue, ICES investigators tracked all patients seen in an Ontario ED for an injury related to a gun, knife, or sharp object between April 1, 2002 and March 31, 2003. They compared gun-related injuries to injuries associated with knives and sharp objects, as well as presented population-based rates by gender, age, urgency, intent, and admission rates.

The results showed that:

  • Among the 1.2 million ED visits for trauma between 2002 and 2003, 40,240, or 3.4%, were related to guns and knives/sharp objects.
  • Knives or sharp objects accounted for 98% of ED trauma visits, compared to just 1.5% for guns.
  • Males accounted for 65% of ED trauma visits for guns and knives/sharp objects.
  • The highest rate for both gun and knife/sharp objects injuries were found in the 15-24 year old age group (15 per 100,000 population and 674 per 100,000 population, respectively).
  • The injury rates in this age group were much higher than the corresponding rate among adults 25-65 years of age (4 per 100,000 population and 356 per 100,000 population, respectively).
  • Only about 10% of gun and knife/sharp object ED visits were classified as intentional (assault or self-harm).
  • Overall, just 3.1% of knife-related injuries were triaged as very urgent in the ED and only 3.7% required hospital admission, compared with 40% triaged as very urgent and 26% requiring hospitalization due to gun-related injuries.
  • The overall number of deaths in hospital caused by knives (26) and guns (30) were similar; however, the percentage of patients who died in hospital was much higher for gun-related injuries (5%), than for knife/sharp object-related injuries (.06%).

“Our findings provide an estimate of the impact of these sorts of injuries on a population level, as well as on the healthcare system, and provide data upon which to design prevention program strategies,” said Dr. Michael Schull, ICES scientist and senior author of the study.

“Monitoring of ED and hospitalization data over time will help to assess trends and provide evidence for the effectiveness of such strategies,” added Dr. Schull.

The study, “Penetrating trauma in Ontario emergency departments: a population-based study”, is in the January 2007 issue of the Canadian Journal of Emergency Medicine.

Author affiliations: ICES (all authors); School of Kinesiology and Health Science, York University (Dr. Macpherson); Division of Emergency Medicine, Department of Medicine, Sunnybrook Health Sciences Centre (Dr. Schull); Faculty of Medicine, University of Toronto (Dr. Schull).

ICES is an independent, non-profit organization that uses population-based health information to produce knowledge on a broad range of healthcare issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting healthcare needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy.


  • Julie Dowdie
  • Media Relations Officer, ICES
  • (416) 480-4780 or cell (416) 432-8143


Contributing ICES Scientists

Associated Sites

Read the Journal Article