Nonfatal Intentional Self-Harm Gunshot Wound Cases in a Nationally Representative Sample of U.S. Emergency Department Visits.

Background: Firearms are the leading means of suicide in the United States. Research on those who survive injuries associated with intentional self-harm gunshot wounds (GSWs) is limited.

Aims: This study explores differences between patients and injury/event characteristics of cases involving nonfatal intentional self-harm GSWs compared to control cases that sustained nonfatal GSWs that did not involve intentional self-harm.

Method: Analyses used multivariable logistic regression using the Firearm Injury Surveillance Study data (1993-2021). The complex survey structure of the data was accounted for in analysis, producing nationally representative estimates.

Results: There were an estimated 113,012 (95% CI: [53,807.58, 172,216]) nonfatal intentional self-harm GSW injuries seen in U.S. emergency departments between 1993 and 2021, with differences in adjusted odds ratios across sex and incident characteristics. Intentional self-harm shootings were estimated to have an 84% (95% CI: [76.5, 94.1]) case fatality rate. Each year, an estimated average of 3897 patients survive intentional self-harm GSWs in the United States.

Conclusion: Survival of intentional self-harm GSWs is a rare, but nonzero outcome that merits further study.