Lethality of firearm-related injuries in the United States population

Study objective: To characterize differences in the lethality of firearm-re lated injuries in selected demographic subgroups using national representat ive data on fatal and nonfatal firearm-related injuries. We also characteri ze the lethality of firearm-related injuries by intent of injury and anatom ic location of the gunshot wound. Methods: We analyzed case-fatality rates (CFRs) of firearm-related injuries in the United States by using death data from the National Vital Statistic s System and data on nonfatal injuries treated in US hospital emergency dep artments from the National Electronic Injury Surveillance System. National estimates of crude and age-adjusted CFRs are presented by sex, race/ethnici ty, age, intent, and primary body part affected. Results: Each year during the study period (July 1992 through December 1995 ), an estimated 132,687 persons sustained gunshot wounds that resulted in d eath or treatment in an ED. The overall age-adjusted CFR among persons who sustained firearm-related injuries was 31.7% (95% confidence interval [CI] 27.7 to 35.6). The age-adjusted CFR for persons who were alive when they ar rived for treatment in an ED (11.3%; 95% CI 9.4 to 13.2) was about one thir d as large as the overall CFR. The age-adjusted CFR Varied by sex, race/eth nicity, and age, but these differences depended an intent of injury. For as saultive injuries, the age-adjusted CFR was 1.4 times higher for females (2 8.7%) than males (20.6%). For intentionally self-inflicted injuries, the ag e-adjusted CFR was 1.1 higher for males (77.7%) than females (69.1%). For a ssaults, the age-adjusted CFR was 1.5 times higher for whites (29.5%) than blacks (19.2%). For assaultive and intentionally self-inflicted injuries am ong persons 15 years and older the age-specific CFR increased with age. Per sons shot in the head (age-adjusted CFR, 61.0%) were 3.3 times as likely to die as those shot in other body parts (age-adjusted CFR, 18.7%). Conclusion: The lethality of firearm-related injuries was influenced strong ly by the intent of injury and body part affected. The high lethality of fi rearm-related injuries relative to other major causes of injury emphasizes the need to continue prevention efforts and efforts to improve access to ca re and treatment (including emergency medical and acute care services) to r educe the number and increase survivability of firearm-related injuries.