Self-Harm and Interpersonal Violence-Related Injuries: Retrospective Analysis of the American College of Surgeons...

Violence-related injuries (VRI) such as interpersonal violence, intimate-partner violence, and self-harm injuries present a significant public health challenge in the United States. We aimed to explore interpersonal-violence and self-harm injuries, focusing on demographic disparities (age and sex) and mechanisms of injury, including firearm-related violence.

We conducted a retrospective study of VRIs among the US civilian population between 2017-2021. Data were extracted from the American College of Surgeons (ACS) Trauma Quality Programs Participant Use Files. We identified VRIs using the International Classification of Diseases, 10th Rev, with Australian modification E-code series. The dataset was categorized and compared by age, sex, ethnicity, violence intent, and mechanism of injury. This study was a secondary data analysis reporting interpersonal-violence and self-harm injuries among trauma cases from the national trauma database.

The total number of trauma patients in the ACS database was 5,483,016 between 2017-2021 (1.1 million/year). The final analysis included 584,417 (11%) patients with VRIs (interpersonal violence and self-harm), with a mean age of 35 years; 82% were male, 45% White, and 42% Black. Interpersonal violence accounted for 88% of injuries, while 12% were self-harm, with firearm-related violence the most common mechanism of injury (35%). Firearm-related interpersonal violence was common among younger individuals (19-39 years), while non-weaponized interpersonal violence was prevalent among older individuals (≥ 60 years). Blacks had a higher rate of firearm-related interpersonal violence (51%), and Whites had a greater frequency of non-weaponized interpersonal violence. There were 43,089 deaths (7.4%), with 68% resulting from interpersonal-violence and 32% from self-harm injuries. Firearm-related injuries (interpersonal violence and self-harm combined) accounted for 78% of all VRI-related deaths. Mortality was higher in males (7.7%) than in females (5.9%) (P < .001).

There is a significant burden of violence-rated injuries in the US, particularly affecting males, racial minorities, and vulnerable age groups. Firearm-related injuries are the leading cause of death in both interpersonal-violence and self-harm cases. The increase in VRIs during the COVID-19 pandemic highlights the urgent need for targeted public health interventions focused on firearm safety, violence prevention, and mental health support.