Growing severity of US firearm injuries requiring hospital admission since early 90s

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 US healthcare system," say the researchers.

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

So using nationwide hospital data, researchers at Boston University and Columbia University in New York City, analysed inpatient admissions for firearm injuries from 1993 to 2014.

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

Analyses showed a significant (1.4%) 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 US healthcare system."