Gun injuries in the U.S. have become more severe since the 1990s, study says

Texas gunman Devin Kelley’s in-laws attended church he shot up, but weren’t there during the melee
Officials investigate a mass shooting Sunday at the First Baptist Church in Sutherland Springs, Texas, that left 26 people dead. New research shows that gun injuries in the U.S. have become increasingly severe over more than two decades.
(Jay Janner / Austin American-Statesman )

If the purpose of a gun is to inflict serious damage to a body, then these weapons have become increasingly effective, new research shows.

An analysis of U.S. hospital records shows that gun injuries bad enough to land a victim in the hospital grew more severe over the course of two decades. Wounds involving “serious open fractures” — trauma that pairs a break in the skin with a broken bone — increased by 0.61% per year between 1993 and 2013. Meanwhile, gun injuries classified as “minor” fell by 0.74% per year during the study period.

Those figures were based on data from 44 states that participate in the Nationwide Inpatient Sample, a project of the federal Agency for Healthcare Research and Quality that tracks trends in hospital stays. The database notes the reasons for millions of hospital admissions each year, along with the severity of patients’ injuries.

Researchers from Boston University School of Medicine focused on patients who were admitted to hospitals with one of five types of firearms injuries: assaults, unintentional injuries, suicides, legal interventions and shootings of undetermined origins. The seriousness of gun injuries was based on a metric called the New Injury Severity Score.


Among gun-related assaults, serious open fractures increased by 0.75% per year while minor injuries declined by 0.81% per year, the researchers found. There was a similar pattern with unintentional injuries — serious open fractures rose by 0.39% per year while minor injuries fell by 0.63% per year.

For shooting victims classified as young adults, serious open injuries grew by 0.66% per year while minor injuries dropped by 0.77% per year.

All of these changes were too large to be due to chance, the researchers reported.

The results were presented Monday at a meeting of the American Public Health Assn. in Atlanta.


These changes my sound small, but they add up over time. For instance, if you start with 100 serious injuries in 1993 and see that number rise by 0.75% per year, after 21 years you’ll have 17 additional injuries.

A finding that gun injuries have become more severe is bad enough, but the effect is compounded by the fact that advances in medical care have allowed more gunshot victims to survive, noted study coauthor Yi Zuo, a biostatistician at Boston University’s Center for Clinical Translational Epidemiology and Comparative Effectiveness Research. Although these patients don’t die, they don’t necessarily make a complete recovery.

“The majority of patients with gun injuries will live compromised lives with repeated emergency and hospitalization visits, psychological problems and social challenges,” Zuo said in a statement.

A study published last year in the Journal of the American Medical Assn. found that gun injuries became more severe and more deadly between 2000 and 2013. That study, which focused on trauma patients in Denver hospitals, concluded that the death rate for hospitalized gunshot victims rose by an average of 6% every two years.

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