Public healthGrowing severity of U.S. firearm injuries requiring hospitalization since early 1990s

Published 1 March 2018

From 1993 to 2014, 648,662 people were admitted to U.S. hospitals for non-fatal firearm injuries. An analysis of these cases show an annual increase in severity of non-fatal firearm injuries needing hospital admission across the United States since the early 1990s. This increase “reflects a move towards hospitalization of more serious injuries, and outpatient management of less serious injuries across the board, suggesting a mounting burden on the U.S. healthcare system,” say the researchers.

New data published in the journal Trauma Surgery & Acute Care Open show an annual increase in severity of non-fatal firearm injuries needing hospital admission across the United States since the early 1990s.

This increase “reflects a move towards hospitalization of more serious injuries, and outpatient management of less serious injuries across the board, suggesting a mounting burden on the U.S. healthcare system,” say the researchers.

Non-fatal firearm injuries account for about 70 percent of all firearm trauma injuries in the United States, but patterns of severity of these injuries are poorly understood.

BMJ says that researchers at Boston University and Columbia University, using nationwide hospital data, analyzed inpatient admissions for firearm injuries from 1993 to 2014.

Of 648,662 admissions, around 88 percent were male and 12 percent were female. 5.6 percent were among children, 82 percent among young adults (16-45 years) and 12 percent among older adults (46 years and older). The majority were of assaultive intent (389,506, 60 percent), followed by unintentional (157,225, 24 percent), intentional self-harm (55,601, 9 percent) and undetermined (46,330, 7 percent).

Analyses showed a significant (1.4 percent) annual increase in firearm injury severity. “Both males and females and all types of intents of firearm injury demonstrated a comparable significant increase in national trends in firearm hospitalizations injury severity,” say the authors.

Furthermore, although the extent of injury severity was lower in children than adults, “there were increasing temporal trends in injury severity from 1998 to 2014 among children as compared with a consistent increase among adults,” they add.

The researchers say their results “should be interpreted with caution due to some limitations” but conclude: “The severity of hospitalized firearm injuries increased significantly from 1993 to 2014. This annual increase reflects a move towards hospitalization of more serious injuries, and outpatient management of less serious injuries across the board, suggesting a mounting burden on the U.S. healthcare system.”

— Read more in Bindu Kalesan et al., “A multi-decade joinpoint analysis of firearm injury severity,” Trauma Surgery & Acute Care Open 3, no. 1 (2018): e000139 (DOI: 10.1136/tsaco-2017-000139)