1. Patients with unintentional or assault-related firearm injuries had a higher incidence of violence-related arrest.
2. Some firearm injuries classified as accidental may suggest involvement in the cycle of violence.
Evidence Rating Level: 2 (Good)
Study Rundown: The majority of hospitalized nonfatal firearm injuries are due to intentional and interpersonal violence (assault). Effective prevention strategies are therefore critical for reducing the burden of such injuries. In-hospital recovery has been viewed as an important opportunity to provide injured patients with resources to help reduce future violence. These programs typically focus on patients with assault-related firearm injury, rather than accidental injury, as assault-related patients are assumed to be involved in a cycle of interpersonal violence. The authors of this study aimed to examine violence perpetration of patients hospitalized for firearm injury based on intentional and unintentional causes. They observed that patients with unintentional firearm injuries were more likely than those with other unintentional injuries and no injuries to be arrested for a violent crime prior to hospitalization. There are several limitations regarding this study. Primarily, self-inflicted firearm injuries and those of undetermined intent were excluded from the study. Furthermore, race was not taken into account, despite evidence indicating that disadvantaged populations are more likely to be involved in firearm injury. Overall, this study suggests that patients with firearm injuries due to accidental causes may also be involved in the cycle of violence and may also benefit from intervention programs.
In-Depth [retrospective cohort and case control]: The authors conducted both a case-control and retrospective cohort study to assess violence in patients aged 15 years or older hospitalized for nonfatal firearm injuries, other injuries, or a noninjury reason. A total of 245 343 patients were collectively included in this study. As mentioned, patients with unintentional firearm injuries were more likely than those with other unintentional injuries (n = 62 795, odds ratio [OR], 2.01 [95% CI, 1.31 to 3.09]) and no injuries (n = 172 830; OR, 3.43 [CI, 2.22 to 5.32]) to have been arrested for a violent crime before hospitalization. Additionally, the absolute risk for violence-related arrest after hospitalization discharge was also higher among patients hospitalized for unintentional firearm injuries than other patients. A greater proportion of patients in the firearm injury group compared to the other injury and no injury groups were younger than 40 years (73.3% versus 25.8% and 19.4% respectively).
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