A Nationwide Epidemiological Approach to Firearm-Related Emergency Department Visits from 2005-2015

Background: The majority of gun violence research focuses on local data and examines all violent assaults broadly. We analyzed the epidemiological risk factors associated primarily with firearm-related injuries that were managed within emergency departments (ED) nationwide. Methods: This study uses the CDC’s National Hospital Ambulatory Medical Care Survey (NHAMCS) to complete a retrospective analysis of firearm injuries managed within US EDs from 2005-2015. All visits related to intentional injury were examined, and an analysis of gunshot injuries was completed, and compared to other assaults resulting in ED visits. Bivariate analyses and logistic regressions were performed to elucidate the relationship between these visits and patient demographics. Results: From 2005-2015 NHAMCS data, 318,114 patient visits were included which represented an estimated 1.25 billion ED visits. Of these, 644,711 were the result of a gunshot wound. In total, gunshot victims demonstrated increased odds (OR 3.4 95% CI 2.4-4.9, p\u3c0.001) of identifying as Black. These Black gunshot victims were overwhelmingly male (90.2% vs 75.7%) and had a younger average age (26.8 vs 32.8) than their White counterparts. Black patients aged 15 to 25 represented 26.7% of all US ED visits within their age-range, but represented 66.1% (95% CI 49.3-79.7, p\u3c0.001) of gunshot victims and 33.7% (95% CI 29.4-38.2, p\u3c0.001) of all assault victims. In this same age group, Black youth represented a disproportionately smaller proportion of ED visits for self-inflicted injury (15.9%, 95% CI 12.9-19.5). Young Black gunshot victims showed increased odds of being intubated in the ED (OR 20.1, 95% CI 8.0-54.0, p\u3c0.001), dying within or en-route to the ED (OR 13.7, 95% CI 3.5-53.6 P\u3c0.001), having an assault-related injury (OR 57.2, 95% CI 24.4-134.7), or receiving any imaging services (OR 6.4 95% CI 2.6-15.7 p\u3c0.001). Conclusion: Black male youth between the ages 15 and 25 are particularly at risk for sustaining gun violence related injuries. This same subset of patients is more likely to utilize an increased number of resources within EDs for management of injuries