The Hidden Burden of Mental Health Outcomes Following Firearm-related Injures

Bellal Joseph, Kamil Hanna, Rachael A. Callcut, Jamie J. Coleman, Joseph V. Sakran, Leigh A. Neumayer

Research output: Contribution to journalArticlepeer-review

24 Scopus citations


Objectives:Examine the effect of different types of firearms on readmission due to acute stress disorder (ASD) and/or post-Traumatic stress disorder (PTSD) in firearm-injury victims.Background:Survivors of firearm-related injuries suffer long-Term sequelae such as disability, work loss, and deterioration in the quality of life. There is a paucity of data describing the long-Term mental health outcomes in these patients.Methods:We performed a 5-year (2011-2015) analysis of the Nationwide Readmission Database. All adult patients with firearm injuries were stratified into 3 groups by firearm type: Handgun, shotgun, and semiautomatic rifle. Outcome measures were the incidence and predictors of ASD/PTSD.Results:A total of 100,704 victims of firearm-related injuries were identified, of which 13.3% (n = 13,393) were readmitted within 6 months of index hospitalization, 6.7% (n = 8970) of these due to ASD/PTSD. Mean age was 34±14 years, 88% were men. Of those readmitted due to ASD/PTSD, 24% (n = 2153) sustained a handgun-related injury on index hospitalization, 12% (n = 1076) shotgun, and 64% (n = 5741) semiautomatic gun (P = 0.039). On regression analysis, semiautomatic gun and shotgun victims had higher odds of developing ASD/PTSD upon readmission [odds ratio (OR): 2.05 (1.10-4.12) and OR: 1.41 (1.08-2.11)] compared to handgun. Female sex [OR: 1.79 (1.05-3.05)] and younger age representing those younger than 25 years [OR: 4.66 (1.12-6.74)] were also independently associated with higher odds of ASD/PTSD.Conclusions:Apart from the lives lost, survivors of semiautomatic rifle-And shotgun-related injuries suffer long-Term mental health sequalae. These secondary and debilitating mental health outcomes are important considerations for capturing the overall burden of the disease.

Original languageEnglish (US)
Pages (from-to)593-601
Number of pages9
JournalAnnals of surgery
Issue number4
StatePublished - Oct 1 2019


  • acute stress disorder
  • handgun
  • mental health outcomes
  • post-Traumatic stress disorder
  • readmission
  • semiautomatic rifle
  • shotgun

ASJC Scopus subject areas

  • Surgery


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