A new Johns Hopkins study of more than 75,000 teenagers and children who suffered a firearm-related injury between 2006 and 2014 pinpoints the financial burden of gunshot wounds and highlights the increasing incidence of injury in certain age groups.

A report of the analysis will be published in JAMA Pediatrics on Oct. 29, 2018. In light of recent school shootings such as the February 2018 mass shooting at the Marjory Stoneman Douglas High School in Florida, which killed 17 students and teachers and wounded 17 more, the researchers point to an urgent need to understand trends in firearm-related injuries among the youth population.

"While mass shootings garner significant media and social attention, unfortunately they're not a good reflection of the actual burden of firearm-related injuries. In our study, we found that for every 100,000 teenagers and children arriving to the emergency department, 11 come for a gun-related injury. In other words, this represents over 8,300 children and teenagers each year who come to the emergency department to be treated for a gunshot wound," says Faiz Gani, M.D., a research fellow in the Johns Hopkins Surgery Center for Outcomes Research and one of the report's authors.

Using the Healthcare Cost and Utilization Project Nationwide Emergency Department Sample, the largest all-payer emergency department (ED) database, the researchers analyzed data from a nationally representative sample of 75,086 people younger than age 18 in the U.S. who arrived alive at an ED with a firearm-related injury.

Approximately 86 percent of patients in the study group were male with an average age of 15. Throughout the study period, males were five times more likely to visit the ED for a firearm-related injury than females, and males ages 15-17 saw the highest incidence, with 85.9 ED visits per 100,000 people. The most common reasons for injury included assault (49 percent), unintentional injuries (38.7 percent) and suicides (2 percent). Overall, 6 percent of these teenagers and children died in the ED or as an inpatient after their injury.

The average ED and inpatient charges were $2,445 and $44,966 per visit, respectively, resulting in approximately $270 million in annual firearm-related injury charges.

"Our study not only highlights the substantial clinical burden and loss of life associated with gunshot wounds, but also reiterates the large economic and financial consequences of these injuries to patients and their families," said Gani. "Unfortunately, these numbers are likely the tip of the iceberg as we were unable to account for subsequent costs for long-term therapy / rehabilitation or expenses associated with lost work for the parents. As a system we need to do much better and can only improve if we focus our efforts to understand these injuries and develop policies that prevent these injuries to our children."

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