Patterns of Firearm Injury Across a Rural State: A 10-Year Single Center Experience

BackgroundFirearm injuries are among the leading causes of injury-related morbidity in the United States. While firearm fatalities represent the most severe outcome, firearm injuries impose substantial physical, psychological, and economic burdens. We employed geospatial methods to describe the distribution of injuries and examined associations between three major intents of firearm injury, key sociodemographic factors, and outcomes.MethodsA 10-year retrospective analysis of our Level 1 institution's trauma registry for all individuals who presented with a firearm injury between 2015 and 2024 was conducted. Patients were excluded if their primary mechanism of injury was not due to a firearm and if their home residential address was not documented.ResultsTotal firearm injuries have increased over the past decade with 110 (34%) that were self-harm, 104 (33%) occurring from an assault, and 106 (33%) that were unintentional/accidental in mechanism. White, insured males were disproportionately represented among self-harm related firearm injuries, associated with more severe trauma, higher rates of ICU-level care, and longer hospital stays. In contrast, Black individuals were more commonly victims of firearm assaults, which along with unintentional/accidental injuries, were more likely to result in discharge to home without additional services. Fifty-eight percent of patients with self-harm intent had the highest need for the ICU, which is likely a direct reflection of the lethality and injury patterns associated with self-inflicted firearm wounds.DiscussionOur findings indicate that intent plays a critical role in determining the severity and required level of care following firearm injuries.