Firearm-Related Hospitalization and Risk for Subsequent Violent Injury, Death, or Crime Perpetration: A Cohort Study
Abstract
Background Risk for violent victimization or crime perpetration after firearm-related hospitalization (FRH) must be determined to inform the need for future interventions. Objective To compare the risk for subsequent violent injury, death, or crime perpetration among patients with an FRH, those hospitalized for noninjury reasons, and the general population. Design Retrospective cohort study. Setting All hospitals in Washington. Patients Patients with an FRH and a random sample of those with a non-injury-related hospitalization in 2006 to 2007 (index hospitalization). Measurements Primary outcomes included subsequent FRH, firearm-related death, and the combined outcome of firearm- or violence-related arrest ascertained through 2011. Results Among patients with an index FRH (n = 613), rates of subsequent FRH, firearm-related death, and firearm- or violence-related arrest were 329 (95% CI, 142 to 649), 100 (CI, 21 to 293), and 4221 (CI, 3352 to 5246) per 100 000 person-years, respectively. Compared with the general population, standardized incidence ratios among patients with an index FRH were 30.1 (CI, 14.9 to 61.0) for a subsequent FRH and 7.3 (CI, 2.4 to 22.9) for firearm-related death. In survival analyses that accounted for competing risks, patients with an index FRH were at greater risk for subsequent FRH (subhazard ratio [sHR], 21.2 [CI, 7.0 to 64.0]), firearm-related death (sHR, 4.3 [CI, 1.3 to 14.1]), and firearm- or violence-related arrest (sHR, 2.7 [CI, 2.0 to 3.5]) t…
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Without any interventions after discharge, individuals hospitalized with firearm injuries have a 7.3-fold greater chance of dying from a firearm injury than those in the general population.
“Without any interventions after discharge, individuals hospitalized with firearm injuries have a 30-fold greater chance of being re-hospitalized with a firearm injury and a 7.3-fold greater chance of dying from a firearm injury than those in the general population [16].”
From Firearm injuries in Missouri (2023) · cites this paper as [16]
Without any interventions after discharge, individuals hospitalized with firearm injuries have a 30-fold greater chance of being re-hospitalized with a firearm injury than those in the general population.
“Without any interventions after discharge, individuals hospitalized with firearm injuries have a 30-fold greater chance of being re-hospitalized with a firearm injury and a 7.3-fold greater chance of dying from a firearm injury than those in the general population [16].”
From Firearm injuries in Missouri (2023) · cites this paper as [16]
The comprehensive and representative sample may account for the higher recurrent injury observed in this study compared to others reporting recurrent firearm injury ranging from one to 10% across a variety of clinical and geographic settings and time periods.
“This may account for the higher recurrent injury observed in this study compared to others reporting recurrent firearm injury ranging from one to 10% across a variety of clinical and geographic settings and time periods.15,18,33-44”
From Incidence of and Factors Associated With Recurrent Firearm Injury Among Patients Presenting to St. Louis Trauma Centers, 2010 to 2019 (2023) · cites this paper as [35]
Among the four studies that conducted a survival analysis, cumulative incidence for recurrent firearm injuries ranged from approximately 2% after five years to 16% after 10 years.
“Among the four studies that conducted a survival analysis, cumulative incidence for recurrent firearm injuries ranged from approximately 2% after five years to 16% after 10 years.18,35,42,44”
From Incidence of and Factors Associated With Recurrent Firearm Injury Among Patients Presenting to St. Louis Trauma Centers, 2010 to 2019 (2023) · cites this paper as [35]
The time-based approach is most often applied to studies of firearm injury recurrence, with days since prior injury ranging from 1 to 90 days depending on the study.
“The time-based approach is most often applied to studies of firearm injury recurrence, with days since prior injury ranging from 1 to 90 days, depending on the study [7][8][9]”
From Machine learning classification of new firearm injury encounters in the St Louis region: 2010-2020 (2024) · cites this paper as [8]
Two proxy measures commonly used in the existing literature are ED visits and time between firearm injury encounters.
“Two proxy measures commonly used in the existing body of literature are (1) ED visits and (2) time between firearm injury encounters.2,4-9”
From Machine learning classification of new firearm injury encounters in the St Louis region: 2010-2020 (2024) · cites this paper as [8]
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References 40 · Cited by 150
- Authors
- Rowhani-Rahbar, A., Zatzick, D., Wang, J., Mills, B. M., Simonetti, J. A., Fan, M. D., & Rivara, F. P.
- Affiliations
- From the University of Washington, Seattle, Washington.
- University of Washington (US)
- Venue
- Annals of Internal Medicine
- Publisher
- American College of Physicians
- Published
- 2015-04-07
- Volume
- 162
- Issue
- 7
- Pages
- 492-500
- ISSN
- 0003-4819 (ISSN-L)
- 1539-3704
- OpenAlex
- W2152980656
- Cited by
- 150
- References
- 40
- Citations by year
- 2026: 12 · 2025: 16 · 2024: 12 · 2023: 17 · 2022: 18 · 2021: 16 · 2020: 7 · 2019: 16 · 2018: 8 · 2017: 9 · 2016: 10 · 2015: 7 · 2012: 1
- FWCI
- 14.22
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Annals of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Health › Gun Ownership and Violence Research
- Social Sciences › Sociology and Political Science › Crime Patterns and Interventions
- Social Sciences › Sociology and Political Science › Homicide, Infanticide, and Child Abuse
- Keywords
- firearm-related injuries, violent injury, firearm deaths, violent victimization, hospitalization outcomes, competing risks
- MeSH terms
- Adult, Crime, Female, Firearms, Hospitalization, Humans, Male, Middle Aged, Retrospective Studies, Risk Factors, Violence, Washington, Wounds, Gunshot, Young Adult
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