{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T22:00:03Z","timestamp":1790892003799,"version":"4.1.0"},"reference-count":20,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Early identification and transport of penetrating trauma patients improve survival. Acoustic gunshot detection systems (ShotSpotter) may speed emergency response, but clear evidence for reduced mortality is lacking. This study examines whether ShotSpotter can reduce violent community death rates and affect resource utilization in a mid-sized city.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively reviewed gunshot wound patients from March 2019 to August 2023, before and after ShotSpotter implementation (August 2021). We analyzed geographic factors, blood product use, and mortality. Bayesian modeling estimated mean gunshot death rate per 100K in each group, accounting for zip code-specific trends over time. Multivariate Poisson regression estimated mean blood packets per patient for both groups, before and after ShotSpotter deployment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      There were 575 patients presenting with firearm-related injuries in Winston-Salem during the study period, with 202 in the ShotSpotter area (100 pre-ShotSpotter, 102 post-ShotSpotter) and 373 in non-ShotSpotter areas (179 pre-ShotSpotter, 194 post-ShotSpotter). Following ShotSpotter implementation, gunshot mortality rates in the ShotSpotter area increased significantly, but remained unchanged in non-ShotSpotter areas remained unchanged (RR 5.61, 95% CrI: 1.06, 73). Whole blood use did not differ between groups, but blood component use increased significantly in the ShotSpotter group (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>ShotSpotter deployment was associated with increased resource utilization. However, the study design does not allow determination of whether this reflects improved patient capture, changes in injury severity, or other unmeasured factors. Despite this, no improvement in community death rates or hospital mortality was observed, suggesting detection alone may be insufficient without coordinated emergency medical response.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348261494197","type":"journal-article","created":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T14:01:58Z","timestamp":1790776918000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Building a Trauma System Through Detection: ShotSpotter Technology and Increased Capture of Injured Patients"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3882-0325","authenticated-orcid":false,"given":"Hope E.","family":"Werenski","sequence":"first","affiliation":[{"name":"Wake Forest University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea M.","family":"Boyd Tressler","sequence":"additional","affiliation":[{"name":"Wake Forest University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2683-820X","authenticated-orcid":false,"given":"Heather D.","family":"Ots","sequence":"additional","affiliation":[{"name":"Wake Forest University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian N.","family":"White","sequence":"additional","affiliation":[{"name":"Wake Forest University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary Alyce","family":"McCullough","sequence":"additional","affiliation":[{"name":"Wake Forest University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7429-1240","authenticated-orcid":false,"given":"Gregory R.","family":"Stettler","sequence":"additional","affiliation":[{"name":"Wake Forest University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin D.","family":"Avery","sequence":"additional","affiliation":[{"name":"Wake Forest University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,30]]},"reference":[{"key":"e_1_3_3_2_2","volume-title":"CDC WISQARS - Web-Based Injury Statistics Query and Reporting System","unstructured":"CDC WISQARS - Web-Based Injury Statistics Query and Reporting System. Centers for Disease Control and Prevention. Accessed August 25, 2024.https:\/\/wisqars.cdc.gov\/"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2015.01.008"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1017\/s1049023x00041947"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.4103\/0974-2700.106320"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2019.10.042"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000002483"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11524-021-00515-4"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","unstructured":"Carr J Doleac JL. The geography incidence and underreporting of Gun violence: new evidence using shotspotter data. Preprint posted online April 26 2016. 2770506. doi:10.2139\/ssrn.2770506.","DOI":"10.2139\/ssrn.2770506"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1057\/s41284-022-00329-2"},{"key":"e_1_3_3_11_2","unstructured":"Frank J Rogan D Watkins C. Field Evaluation of the ShotSpotter Gunshot Location System: Final Report on the Redwood City Field Trial. University of Cincinnati Division of Criminal Justice."},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1117\/12.784547"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","unstructured":"Piza EL Hatten DN Mohler GO Carter JG Cho J. Gunshot detection technology effect on Gun violence in Kansas City Missouri: a microsynthetic control evaluation. Criminology & Public Policy. n\/a(n\/a);23:863-892. doi:10.1111\/1745-9133.12648.","DOI":"10.1111\/1745-9133.12648"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.18789"},{"key":"e_1_3_3_15_2","unstructured":"Winston-salem city North Carolina - census bureau search. Accessed January 17 2025.https:\/\/data.census.gov\/all?q=Winston-Salem_city _North_Carolina"},{"key":"e_1_3_3_16_2","volume-title":"ZCTA5 27105 - Census Bureau Profile","unstructured":"ZCTA5 27105 - Census Bureau Profile. 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