S. C. Gale1, J. Kocik1, J. S. Murry1, V. Y. Dombrovskiy1 1East Texas Medical Center,Acute Care Surgery,Tyler, TX, USA
Introduction:
Despite the important social, political, and financial implications, the nationwide annual burden and trends for gun-related hospital admissions in the US are not well described. We examined the epidemiology of all gunshot wound (GSW) related hospital admissions in the US over a 12-year period
Methods:
The Nationwide Inpatient Sample was queried (2003-2014) for GSW-related admissions using all pertinent ICD-9-CM codes. Demographics, injury circumstances, and mortality were compiled and examined. Chi square, t-test and Armitage trend test were used. P<0.05 was significant.
Results:
Of 445,884,043 US admissions over 12 years, 354,043 (0.08%) sustained GSW. Mean GSW admissions were 29504 ± 3127 annually. Notwithstanding a 2010 spike, GSW admissions trended lower over time (Figure 1) and remained stable and very small proportion of total admissions (0.076% to 0.077%; p=0.50). Over 12 years, the population rate of GSW hospitalizations per 100000 decreased from 9.7 to 8.6 (p<0.0001). Demographically, patients were most likely male (89%), African-American (49%), in the South (43%), and uninsured (p<0.0001 for all). Mean age was 31±13. Data on circumstances (assault (64.4%), unintentional (24.4%), suicide (9.3%), and legal (2%)) demonstrate that rates for assaults decreased significantly over time, while suicide attempts, unintentional injury and legal intervention all remained stable. Mortality was 8% with a slight increase over time (p<0.04) and was highest amongst suicides (34%), followed by legal intervention (7.8%). During the study period, costs increased by 24% (p<0.0001) while length of stay remained stable at 7 days. In 2014, the uninsured rate markedly dropped while rates for Medicaid enrollment sharply rose.
Conclusion:
National data demonstrate an overall decrease in GSW-related hospitalizations over the 12-year period – most attributable to a decrease in assault-related shootings. Suicide attempts were most likely associated with in-hospital mortality. Despite high-profile events, hospitalization data do not support publicized claims of increased gun-related violence in the United States.
