Table 1.
12-month rates of firearm suicide and associated SMRs among California emergency department patients presenting in 2009-2013, according to patient diagnostic group.
| Diagnostic group | Total unique individuals in diagnostic group |
Firearm suicide deaths, n |
Incidence rate per 100,000 person-years |
Standardized mortality ratio | ||
|---|---|---|---|---|---|---|
| Rate | 95% CI | SMRa | 95% CI | |||
| Chronic illnessb | ||||||
| Myocardial infarction | 181,715 | 22 | 13.5 | 8.9, 20.5 | 2.45 | 1.53, 3.71 |
| Congestive heart failure | 238,096 | 60 | 30.2 | 23.4, 38.9 | 5.10 | 3.89, 6.56 |
| Cerebrovascular disease | 331,106 | 53 | 17.9 | 13.7, 23.5 | 3.24 | 2.43, 4.23 |
| COPD | 743,180 | 85 | 11.8 | 9.6, 14.6 | 2.31 | 1.85, 2.86 |
| Diabetes | 189,889 | 22 | 12.0 | 7.9, 18.3 | 2.34 | 1.47, 3.55 |
| Other chronic illness | 168,832 | 31 | 20.8 | 14.7, 29.6 | 3.71 | 2.52, 5.27 |
| Cancerc | 217,082 | 80 | 55.1 | 44.3, 68.7 | 7.45 | 5.91, 9.28 |
| Non-cancerous paind | ||||||
| Back pain | 877,036 | 121 | 14.0 | 11.7, 16.8 | 2.79 | 2.32, 3.33 |
| Headache | 712,109 | 52 | 7.4 | 5.6, 9.7 | 1.48 | 1.10, 1.94 |
| Joint disorders | 507,466 | 45 | 9.0 | 6.7, 12.1 | 1.79 | 1.31, 2.40 |
| Other non-cancerous pain | 320,672 | 43 | 13.8 | 10.2, 18.6 | 2.71 | 1.96, 3.65 |
| Injurye | ||||||
| Unintentional injury | 6,095,058 | 574 | 9.6 | 8.9, 10.4 | 1.90 | 1.75, 2.07 |
| Assault injury | 413,427 | 49 | 11.9 | 9.0, 15.8 | 2.40 | 1.77, 3.17 |
| Deliberate self-harm injury | 136,210 | 119 | 88.7 | 74.1, 106.1 | 17.67 | 14.64, 21.14 |
| Mental disorderf | 654,704 | 262 | 40.6 | 35.9, 45.8 | 8.09 | 7.14, 9.14 |
| Substance useg | 353,736 | 147 | 42.3 | 36.0, 49.8 | 8.40 | 7.10, 9.88 |
Abbreviations: CI, confidence interval; COPD, chronic obstructive pulmonary disease.
Calculated from California data for 2009-2014 from CDC WISQARS (external causes), standardized to match the distribution of gender, age category, and race/ethnicity category of the corresponding group from the ED cohort.
Chronic illness diagnostic groups’ ICD-9-CM codes: Myocardial infarction, 410.x, 412.x; congestive heart failure, 398.91, 402.01, 402.11, 402.91, 404.01, 404.03, 404.11, 404.13, 404.91, 404.93, 425.4-425.9, 428.x; cerebrovascular disease, 362.34, 430.x-438.x; COPD, 416.8, 416.9, 490.x-505.x, 506.4, 508.1, 508.8; diabetes, 250.0-250.3, 250.8, 250.9, 250.4-250.7; other chronic disease, 042.x-044.x, 070.22, 070.23, 070.32, 070.33, 070.44, 070.54, 070.6, 070.9, 093.0, 290.x, 294.1, 331.2, 334.1, 342.x, 343.x, 344.0-344.6, 344.9, 403.01, 403.11, 403.91, 404.02, 404.03, 404.12, 404.13, 404.92, 404.93, 437.3, 440.x, 441.x, 443.1-443.9, 446.5, 447.1, 456.0-456.2, 531.x-534.x, 557.1, 557.9, 570.x, 571.x, 572.2-572.8, 573.3, 573.4, 573.8, 573.9, 582.x, 583.0-583.7, 585.x, 586.x, 588.0, 710.0-710.4, 714.0-714.2, 714.8, 725.x, V42.0, V43.4, V42.7,V45.1, V56.x.
Cancer diagnostic group’s ICD-9-CM codes: 140-239, 258.02-258.03, 511.81, 789.x, 795.x, 796.70-796.76, V10.x, V12.72, V58.x, V66.1-V66.2, V67.1-V67.2.
Non-cancerous pain diagnostic groups’ ICD-9-CM codes: Back pain, 720-724.x; headache, 339.0-339.x, 346.0-346.x, 784.0; joint disorders, 713-716.x, 718-719.x; other non-cancerous pain, 307.89, 307.81, 388.29, 729.1, 780.96, 800.0-804.x, 850.0-854.x, 907.0, V155.2.
Injury diagnostic groups’ ICD-9-CM codes: Unintentional injury, E000-E019.x, E029-E030.x, E800-E806.x, E810-E838.x, E840-E858.x, E860-E888.x, E890-E928.x; assault injury, E960.0-E960.9; deliberate self-harm injury, E950.0-E950.8.
Mental disorder diagnostic group’s ICD-9-CM codes: 293.8x, 295.x, 296.x, 297.x, 298.x, 300.0-300.5x, 300.89, 300.9, 308.0-308.9, 309.x, 311.0-314.x, V62.84.
Substance use diagnostic group’s ICD-9-CM codes: 291.x, 292.x, 303.x, 304.x, 305.00-305.03, 305.20-305.93, 357.5, 425.5, 535.3, 571.0-571.3, 648.30-648.34, 655.50-655.53, 760.71-760.73, 760.75, 779.5, 965.00-965.02, 965.09, 980.0, V65.42.