The database is a 20% stratified sample of all hospital admissions in the U.S. NIS is the largest public database maintained by the Healthcare Cost and Utilization Project (HCUP) containing information from more than 4000 hospitals and 7 million in-hospital admissions across 44 states in the United States for the year 2011. Hospital admission data was obtained from the National Inpatient Sample (NIS) database for the year 2011. We hypothesized that strict firearm legislations lower the incidence of firearm related hospital admissions and mortality. The aim of this study was to determine the association between the rigorousness of firearm laws across different states and the rate of firearm related injuries, and mortality. We for the first time used the Brady scorecard to assess the level of strictness in firearm laws across different states. 9 The higher the Brady Score for each state, the stricter the firearm laws in that state. Brady scorecard was based on policy regulations such as background checks on gun sales reporting lost or stolen firearms and prohibiting dangerous people from purchasing weapons. 6- 8 Every two years the Brady Campaign to Prevent Gun Violence issues a 100-point scorecard (Brady scorecard) that assigns a numerical value to each state based on the strength of its firearm laws. Limited numbers of previous studies have assessed the association between the incidence of firearm related mortality and strictness of firearm laws across the states. The shooting of Arizona Congresswoman Gabriel Gifford in 2011 and the mass shooting of Sandy Hook Elementary School in 2012 once again surfaced the debate on need for stricter firearm laws. Despite the hue and cry for needing stricter firearm laws, there has been limited legislative progress on this forefront since the Gun Control Act of 1968 following the Kennedy assassination. Lawmakers that tried to limit the access of firearms have met with criticism for violating the rights of citizens protected by the Second Amendment.
Ever since then, possession of firearms has been a matter of debate due to concerns for public safety. The Second Amendment to the constitution of the United States was passed in 1791 as a part of the Bill of Rights, which protects the rights of individuals to keep and bear firearms. 4 The overall economic burden associated with gun violence actually exceeds more than $100 billion every year. Along with the loss of life, gun violence related injuries exert a major burden on the US health system costing up to $2.3 billion annually. 3 Firearm related deaths disproportionately involve the younger population resulting in premature deaths. 2 These numbers state that there are more lives lost in seven weeks at the hands of firearm related violence than the total number of lives lost in seven years of Iraq War. 1 This has resulted in the loss of 32 lives and the treatment of 140 people every single day for gun related violence. The United States ranks number 1 in the list of countries with most privately owned guns with 101 guns for every 100 individuals.
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