Department of Medicine and Community Health Sciences, Boston University School of Medicine and Public Health, MA.
Division of Vascular and Endovascular Surgery, Boston University School of Medicine and Boston Medical Center, MA.
Surgery. 2021 May;169(5):1188-1198. doi: 10.1016/j.surg.2020.11.009. Epub 2020 Dec 29.
Age- and intent-related differences in the burden and costs of firearm injury treated in emergency departments are not well-documented.
We performed a serial cross-sectional study of the Healthcare Cost and Utilization Program Nationwide Emergency Department Survey from 2006 to 2016. We used International Classification of Diseases diagnoses codes revisions 9 and 10 to identify firearm injuries. We calculated survey-weighted counts, proportions, means, and rates and confidence intervals of national, age-specific (0-4, 5-9, 10-14, 15-17, 18-44, 45-64, 65-84, >84) and intent-specific (assault, unintentional, suicide, undetermined) emergency department discharges for firearm injuries. We used survey-weighted regression to assess temporal trends.
There was a total of 868,483 (25.5 per 100,000) emergency department visits for firearm injuries from 2006 to 2016, and 7.8% died in the emergency department. Overall, firearm injury rates remained steady (P = .78). The largest burden was among those 25 to 44 years of age, but their rates remained stable (10.8 per 100,000). Overall assault injuries declined from 39.7% to 36.4%, and overall unintentional injuries increased from 46.4% to 54.7%. Legal-intervention injuries declined from 0.6 to 0.3 per 100,000. The charges (total $4,059,070,364, $369,006,396/year) increased across time in age and intent groups. The mean predicted charges increased from $1,922 to $3,348 in those alive versus $3,741 to $6,515 among those who died.
Interventions and programs to manage the consequences of firearm injury in persons who live with ongoing morbidity and economic burden are warranted.
在急诊科接受治疗的枪支伤害的负担和费用与年龄和意图相关的差异尚未得到充分记录。
我们对 2006 年至 2016 年全国急诊部调查的医疗保健成本和利用计划进行了一系列横断面研究。我们使用国际疾病分类诊断代码修订版 9 和 10 来确定枪支伤害。我们计算了调查加权计数、比例、平均值和全国范围内、年龄特定（0-4、5-9、10-14、15-17、18-44、45-64、65-84、>84）和意图特定（攻击、非故意、自杀、未确定）枪支伤害急诊出院率。我们使用调查加权回归来评估时间趋势。
2006 年至 2016 年，共有 868483 例（每 100000 人中有 25.5 例）因枪支伤害而到急诊就诊，其中 7.8%在急诊死亡。总体而言，枪支伤害率保持稳定（P=0.78）。最大的负担是 25 至 44 岁的人群，但他们的比例保持稳定（每 100000 人中有 10.8 例）。总体攻击伤害从 39.7%下降到 36.4%，总体非故意伤害从 46.4%上升到 54.7%。合法干预伤害从每 100000 人 0.6 例下降到 0.3 例。年龄和意图组的费用（总计 4059070364 美元，每年 369006396 美元）随着时间的推移而增加。在活着的人中，平均预测费用从 1922 美元增加到 3348 美元，而在死亡的人中，从 3741 美元增加到 6515 美元。
需要干预和计划来管理枪支伤害后果，这些后果与那些持续存在发病率和经济负担的人有关。
