National estimates of nonfatal firearm-related injuries. Beyond the tip of the iceberg

JAMA. 1995 Jun 14;273(22):1749-54.


Objective: To describe the magnitude and characteristics of nonfatal firearm-related injuries treated in hospital emergency departments in the United States and to compare nonfatal injury rates with firearm-related fatality rates.

Design: Data were obtained from medical records for all firearm-related injury cases identified using the National Electronic Injury Surveillance System (NEISS) from June 1, 1992, through May 31, 1993.

Setting: NEISS comprises 91 hospitals that are a stratified probability sample of all hospitals in the United States and its territories that have at least six beds and provide 24-hour emergency service.

Main outcome measures: Numbers and population rates for nonfatal and fatal firearm-related injuries.

Results: An estimated 99,025 (95% confidence interval [CI], 56,325 to 141,725) persons (or 38.6 per 100,000 population; 95% CI, 22.0 to 55.2) were treated for nonfatal firearm-related injuries in US hospital emergency departments during the study period. The rate of nonfatal firearm-related injuries treated was 2.6 (95% CI, 1.5 to 3.7) times the national rate of fatal firearm-related injuries for 1992.

Conclusions: Nonfatal firearm-related injuries contribute substantially to the overall public health burden of firearm-related injuries. NEISS can be useful to monitor the number of nonfatal firearm-related injuries in the United States. A national surveillance system is needed to provide uniform data on firearm-related injury morbidity and mortality for use in research and prevention efforts.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Child, Preschool
  • Emergency Service, Hospital / statistics & numerical data*
  • Female
  • Humans
  • Infant
  • Male
  • Middle Aged
  • Population Surveillance
  • United States / epidemiology
  • Wounds, Gunshot / epidemiology*
  • Wounds, Gunshot / mortality