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Firearm Reinjury and Subsequent Mortality: Identifying a High-Risk Population for Hospital-Based Violence
Stephen E Gregg1, Saeram Oh1, Alex Dai1
1Division of Trauma and Acute Care, Department of Surgery, The Brody School of Medicine, East Carolina University, Greenville, NC, USA.
The American Surgeon
|July 25, 2026
Summary
Firearm reinjury affects 4% of survivors, with young males, Black individuals, and assault victims most impacted. This high-risk group has a 35.5% mortality rate, highlighting a critical need for intervention.
Area of Science:
- Public Health
- Trauma Surgery
- Epidemiology
Background:
- Firearm survivors face increased risk of subsequent firearm trauma.
- Firearm reinjury epidemiology and risk factors are not well-understood.
Purpose of the Study:
- To characterize the epidemiology and risk factors of firearm reinjury using a statewide trauma registry linked with vital records.
Main Methods:
- Utilized the North Carolina Trauma Registry (2013-2023) linked with Vital Records death certificates.
- Identified patients with firearm injuries and analyzed demographics and injury data.
- Calculated reinjury rates, adjusted for mortality.
Main Results:
- Among 20,566 patients, 3.4% experienced reinjury (adjusted rate 4.2%).
- Reinjured patients were younger, more likely male, Black, and injured by assault (all P < 0.001).
- Overall mortality was higher in reinjured patients (35.5% vs 15.5%, P < 0.001).
Conclusions:
- Firearm reinjury impacts approximately 4% of survivors, with a significant out-of-hospital mortality rate.
- Younger, male, Black individuals injured by assault are disproportionately affected by reinjury.
- Identified a critical period for intervention in this high-risk population, supporting violence intervention programs.
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