Trends in firearm-related injuries in Washington state, 1989-1995

Study objectives: To describe the incidence and outcome of firearm-related injuries and to describe trends over time. Design: Information about firearm-related injuries in Washington state was extracted from computerized death certificate and hospital discharge files for the period 1989 through 1995. Cases seen only in emergency departments were estimated using initial results from a statewide firearm injury surveillance system. Results: An estimated 9,995 persons were shot during the 7-year period (incidence 28.0/100,000 person-years); 2,944 persons (29%) required ED care only, 2,864 persons (29%) were hospitalized and survived, and 4,187 persons (42%) died. Survival was lowest for suicide attempts (11%), intermediate for assaults (68%), and greatest for unintentional shootings (96%). Most deaths (91%) occurred before hospital admission. From 1989 to 1995, the incidence of firearm-related injuries showed little change: an increase of 4.5%. However, suicidal shootings among persons younger than 35 years increased by 31.3%, and the incidence of firearm related assaults rose by 53.7% among persons of all ages. Survival among all persons who were shot and among hospitalized shooting victims showed little change over time. Conclusion: Firearm-related suicides among the young and assault-related shootings among all persons increased. The estimated proportion of shooting victims who survived did not change over time.