The epidemiology of firearm injuries managed in US emergency departments

Jacob B. Avraham · Spiros Frangos · Charles J. DiMaggio

48 citations0/0 files storedInjury Epidemiology

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Gun Ownership and Violence Research Trauma and Emergency Care Studies Injury Epidemiology and Prevention

Abstract

BACKGROUND: Firearm-related injuries cause significant morbidity and mortality in the United States (US), consuming resources and fueling political and public health discourse. Most analyses of firearm injuries are based on fatality statistics. Here, we describe the epidemiology of firearm injuries presenting to US emergency departments (EDs). METHODS: We performed a retrospective study of the Healthcare Cost and Utilization Program Nationwide Emergency Department Survey (NEDS) from 2009 to 2012. NEDS is the largest all-payer ED survey in the US containing approximately 30 million annual records. Results include survey-adjusted counts, proportions, means, and rates, and confidence intervals of age-stratified ED discharges for firearm injuries. RESULTS: There were 71,111 (se = 613) ED discharges for firearm injuries in 2009; the absolute number increased 3.9% (se = 1.2) to 75,559 (se = 610) in 2012. 18-to-44-year-olds accounted for the largest proportion of total injuries with 52,187 (se = 527) in 2009 and 56,644 (se = 528) in 2012-a 7.2% (se = 1.6) relative rate increase and an absolute increase of 3.3/100,000 (se = 0.7). Firearm injuries among children < 5-years-old increase 16%, and 19% among children 5-to-9-years-old. 136,112 (se = 761)-or 48.2%-of those injured were treated and discharged home without admission; 106,927 (se = 755) were admitted. Firearm deaths represented one-third of all trauma mortality. Three-quarters of those injured resided in neighborhoods with median incomes below $49,250. CONCLUSIONS: Firearm injuries increased from 2009 to 2012, driven by adults aged 18-to-44-years-old, and disproportionately impacting lower socioeconomic communities. Injuries also increased among young children. Firearm injuries remain a continued public health challenge, and a significant source of ED morbidity and mortality.

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References

2015Violent Death Rates: The US Compared with Other High-income OECD Countries, 2010 2014The Epidemiology of Firearm Violence in the Twenty-First Century United States 2010Homicide, Suicide, and Unintentional Firearm Fatality: Comparing the United States With Other High-Income Countries, 2003 1999The Medical Costs of Gunshot Injuries in the United States 2015Race and ethnicity, neighborhood poverty and pediatric firearm hospitalizations in the United States 2013Epidemiology of paediatric firearm injuries in the USA, 2001-2010 2016A Geospatial Analysis of Severe Firearm Injuries Compared to Other Injury Mechanisms: Event Characteristics, Location, Timing, and Outcomes

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