Sex-based differences in post-injury behavioral health readmissions among adolescents hospitalized for firearm...

Adolescents hospitalized for firearm injuries are at high risk for developing behavioral health conditions, yet sex-based differences in these outcomes remain poorly understood.

Using the 2016-2022 Nationwide Readmissions Database, we identified adolescents aged 10-18 hospitalized for firearm injuries and evaluated readmissions for new mental health and substance use disorders within the calendar year of injury. Multivariable logistic regression examined associations between sex and behavioral health outcomes.

Among 27,428 adolescents, females were more likely than males to be readmitted with new mental health diagnoses (3.0% vs. 2.0%, p < 0.001), particularly depression, anxiety, and post-traumatic stress disorder. Female sex was independently associated with new mental health diagnoses (aOR 1.55, 95% CI 1.25-1.92), but not with new substance use disorders on logistic regression. Females also had longer index hospitalizations, adverse discharges, and higher overall readmission rates.

Female adolescents experience distinct health trajectories after firearm injury. Early behavioral health screening should be systematized to ensure timely recognition and treatment for all firearm-injured youth.