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Cited by 37Gun Ownership and Violence ResearchTrauma and Emergency Care StudiesInjury Epidemiology and Prevention

Risk of 90-day readmission in patients after firearm injury hospitalization: a nationally representative retrospective cohort study

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Bindu Kalesan, Yi Zuo, Ramachandran Srini Vasan, Sandro Galea·2019·Journal of Injury and Violence Research
DOI 10.5249/jivr.v11i1.979PMC PMC6420916
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Abstract

BACKGROUND: National conversation has justifiably been concerned with firearm-related deaths and much less attention has been paid to the consequences of surviving a firearm injury. We assessed the risk of hospital readmission, length of stay (LOS) during hospitalization, and costs within 90-days after surviving an index firearm injury and compared these data with pedestrians and occupants involved in motor vehicle crash (MVC). METHODS: Nationwide Readmission Database, a nationally representative readmission database from 2013 and 2014 was used to create a retrospective cohort study. The primary outcome was time-to-first all-cause readmission within 90-days after discharge from the index hospitalization. Secondary outcomes were LOS and hospitalization costs at index events and at 90-days. RESULTS: There were 3,334 (10.5%), 3,818 (10.6%) and 24,672 (9.4%) firearm injury, pedestrian, and occupant MVC readmissions within 90-days. The risk of 90-day readmission among firearm was 20% (HR=1.20, 95%CI=1.09-1.32) and 34% (HR=1.34, 95%CI=1.26-1.44) greater than patients admitted after pedestrian and occupant MVC. The primary causes of firearm readmission were surgical complications, intestinal disorders and open wounds. The mean total costs were lower among patients after firearm injury versus occupant MVC hospitalizations ($9,357 versus $11,032, p=0.028) but mean total LOS was greater (4.48 versus 4.38 days, p=0.003). Medicaid-insured patients had longer LOS at a total lower cost during index hospitalization after firearm injury as compared to MVC occupant injury. Increased LOS and lower costs of 90-day readmissions among firearm patients versus occupant MVC were irrespective of insurance. CONCLUSIONS: The patients surviving a firearm injury have a substantial risk of subsequent hospitalizations, higher than pedestrian or occupant MVC injuries. Medicaid is disproportionately burdened by the costs of treatment of firearm injury.

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  • It is estimated that 20% of patients with a firearm injury will be readmitted to the hospital within 90 days.

    “In fact, it is estimated that 20% of patients with a firearm injury will be readmitted to the hospital within 90 days.3”

    From Machine learning classification of new firearm injury encounters in the St Louis region: 2010-2020 (2024) · cites this paper as [3]

    The Results section reports a 10.5% absolute 90-day readmission rate among firearm-injury patients, not 20%. Its 20% figure describes the higher relative risk compared with pedestrians, not the proportion of firearm-injury patients readmitted. No page number is provided in our copy. (LLM, conf=0.93)

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Cited by

Sorted by citations

Authors
Kalesan, B., Zuo, Y., Vasan, R. S., & Galea, S.
Affiliations
Boston University (US)
ORCID
Venue
Journal of Injury and Violence Research
Publisher
Journal of Injury and Violence Research
Published
2019
Volume
11
Issue
1
Pages
65-80
ISSN
  • 2008-2053 (ISSN-L)
  • 2008-4072
DOI
10.5249/jivr.v11i1.979
PMC
PMC6420916
OpenAlex
W2913862446
Cited by
37
References
0
Citations by year
2025: 1 · 2024: 1 · 2023: 4 · 2022: 23 · 2021: 2 · 2020: 5 · 2019: 1
FWCI
7.56
Type
journal article
Language
en
Open access
Locations
  • Journal of Injury and Violence Research (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Social Sciences › Health › Gun Ownership and Violence Research
  • Health Sciences › Medicine › Emergency Medicine › Trauma and Emergency Care Studies
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Injury Epidemiology and Prevention
Keywords
firearm injuries, hospital readmission, 90-day readmission, motor vehicle crash injuries, pedestrian injuries, occupant injury, length of hospital stay, hospital costs, surgical complications, Medicaid, health care costs
MeSH terms
Accidents, Traffic, Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Child, Child, Preschool, Female, Firearms, Humans, Infant, Infant, Newborn, Length of Stay, Male, Medicaid, Middle Aged, Patient Discharge, Patient Readmission, Retrospective Studies, Risk, United States, Wounds, Gunshot, Injury Severity Score, Multivariate Analysis, Treatment Outcome, Hospital Costs, Young Adult

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