American Surgical Association

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The Hidden Burden of Mental Health Outcomes Following Firearm-Related Injures
Bellal Joseph*1, Kamil Hanna*1, Rachael A. Callcut*2, Jamie J. Coleman*3, Joseph V. Sakran*4, Leigh A. Neumayer1
1The University of Arizona, Tucson, AZ;2University of California San Francisco, San Francisco, CA;3Denver Health, Denver, CO;4The Johns Hopkins Hospital, Baltimore, MD

OBJECTIVE(S): The weapons used in a firearm-related events are essential for firearm policy development. The aim of our study was to examine the effect of different types of firearms on readmission due to acute stress disorder (ASD) and/or post-traumatic stress disorder (PTSD).
METHODS:
We performed a 4-year (2011-2014) analysis of the National Readmission Database. All adult patients who were readmitted secondary to firearm-related ASD/PTSD were stratified into 3 groups by firearm type: handgun, shotgun, and semi-automatic gun. Regression analysis was used to identify predictors of readmission due to ASD/PTSD.
RESULTS:
A total of 100,704 victims of firearm-related injuries were identified, of which 13.3% (n=13,393) were readmitted within 6 months of index-hospitalization, 6.7% (n=8,970) of these due to ASD/PTSD. Mean age was 3414y, 88% were male. Of those readmitted due to ASD/PTSD, 24% (n=2,153) sustained a handgun related injury on index-hospitalization, 12% (n=1,076) shotgun, and 64% (n=5,741) semi-automatic gun (p=0.039). On regression analysis, semi-automatic gun and shotgun victims had higher odds of developing ASD/PTSD upon readmission (OR: 2.05 [1.10-4.12] and OR:1.41 [1.08-2.11]) compared to handgun. Female gender (OR: 1.79 [1.05-3.05]) and younger age representing those <25y (OR: 4.66 [1.12-6.74]) were also independently associated with higher odds of ASD/PTSD.
CONCLUSIONS:
Apart from the lives lost, survivors of semi-automatic gun- and shotgun- related injuries suffer long-term mental health sequalae. These secondary and debilitating mental health outcomes are important considerations for capturing the overall burden of disease secondary to firearm injury.

* By Invitation


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