title: The relation of depression to in-hospital outcomes among adults hospitalized for firearm-related injury.
abstract: BACKGROUND
  Firearm injuries are a major health problem contributing to significant morbidity and mortality. Depression is associated with increased risk of adverse health outcomes in trauma patients and those hospitalized for serious disorders. We examined the relation between preexisting depression and adverse hospital outcomes and related injury severity among adult (>16-years) firearm hospitalizations (FH).
  
  
  METHODS
  Using nationally representative Nationwide Inpatient Sample (2005 to 2011) and survey weighted multinomial logistic regression, we calculated odds ratios (OR) and 95% confidence intervals (95%CI) to determine the risk of care facility discharge and in-hospital mortality by pre-existing depression.
  
  
  RESULTS
  Pre-existing depression was associated with a 3-fold risk of discharge to care facility (OR=2.91, 95%CI=2.57-3.30) and a 2-fold risk of in-hospital mortality (OR=2.05, 95%CI=1.69-2.47). ORs for risk of care facility discharge compared to routine discharge associated with depression among assault/legal-FH, unintentional-FH, suicide-FH and undetermined-FH was 2.73 (95%CI=2.23-3.33), 1.90 (95%CI=1.50-2.41), 1.52 (95%CI=1.26-1.83) and 2.42 (95%CI=1.60-3.67), while risk of inhospital mortality was 0.17 (95%CI=0.05-0.54), 0.60 (95%CI=0.28-1.29), 0.79 (95%CI=0.63-0.98) and 0.74 (95%CI=0.36-1.52).
  
  
  CONCLUSIONS
  Lack of information regarding re-hospitalization due to the cross-sectional data.
  
  
  CONCLUSIONS
  Persons with depression who were hospitalized due to firearm-related injury were less likely to survive than those without depression, and those discharged alive were at higher risk of discharge to a facility. Depression was associated with greater risk of discharge to facility among all intents, and lower risk of in-hospital mortality among assault- and suicide-FH. These findings are important considering the increasing numbers of non-fatal firearm hospitalizations and the associated increase in healthcare expenditure.
authors.affiliation: Columbia University, Mailman School of Public Health, New York, NY, USA; Gun Violence Survivors Foundation, Philadelphia, PA, USA. Electronic address: bindu.kalesan@gmail.com.
authors.forename: Bindu
authors.initials: B
authors.lastname: Kalesan
authors.affiliation: Columbia University, Mailman School of Public Health, New York, NY, USA; Boston University School of Public Health, Boston, MA 02118, USA.
authors.forename: Sandro
authors.initials: S
authors.lastname: Galea
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010351:Patient Discharge / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D013405:Suicide / Q000706:statistics & numerical data; D014948:Wounds, Gunshot / Q000453:epidemiology* / Q000523:psychology
keywords: Care facility discharge; Depression; Firearm injury; in-hospital mortality