Variability in firearm injury among major pediatric trauma centers across the USA

Trauma Surgery & Acute Care Open

article

Kiesha Fraser Doh¹  Sofia Chaudhary¹  Stephanie M Ruest³  Ashkon Shaahinfar⁵  Thomas Chun⁶  Nicholas Cooper⁸  Joel Fein⁹  Alayna Feng^1,11  Katherine Feske-Kirby^1,12  Janet Figueroa^1,13  Colleen K Gutman^1,14  Jacqueline Grupp-Phelan^1,15  Ghid Kanaan⁴  Nora Keathley^1,16  Naghma Khan¹  Katherine McGlamry^1,17  Sage Myers⁹  Michael Nance⁹  Katherine Russell^1,18  Kelli Rowker²  Erica Sheline^1,19  Harold K Simon¹  Claudia R Morris¹ 

[1] Department of Pediatrics and Emergency Medicine, Emory University School of Medicine;Children's Healthcare of Atlanta Inc;Department of Emergency Medicine , Brown University;Department of Emergency Medicine , Hasbro Children's Hospital;Departments of Emergency Medicine and Pediatrics , University of California San Francisco;Department of Emergency Medicine and Pediatrics , Brown University Warren Alpert Medical School;Hasbro Children's Hospital;SUNY Upstate Medical University Hospital;University of Pennsylvania Perelman School of Medicine;Division of Emergency Medicine and Center for Violence Prevention , The Children's Hospital of Philadelphia;Donald and Barbara Zucker School of Medicine at Hofstra/Northwell;The Children's Hospital of Philadelphia;Department of Pediatrics , Emory University;University of Florida College of Medicine;University of California San Francisco;Imagen;Northside Pediatrics;Rollins School of Public Health;University of Colorado Denver School of Medicine;Children's Hospital Colorado

关键词: Firearms;    pediatrics;    Wounds;    Gunshot;   

DOI  :  10.1136/tsaco-2022-001014

学科分类：社会科学、人文和艺术（综合）

来源: BMJ Publishing Group

【 摘 要 】

Objectives In 2020, firearm injuries surpassed automobile collisions as the leading cause of death in US children. Annual automobile fatalities have decreased during 40 years through a multipronged approach. To develop similarly targeted public health interventions to reduce firearm fatalities, there is a critical need to first characterize firearm injuries and their outcomes at a granular level. We sought to compare firearm injuries, outcomes, and types of shooters at trauma centers in four pediatric health systems across the USA.Methods We retrospectively extracted data from each institution’s trauma registry, paper and electronic health records. Study included all patients less than 19 years of age with a firearm injury between 2003 and 2018. Variables collected included demographics, intent, resources used, and emergency department and hospital disposition. Descriptive statistics were reported using medians and IQRs for continuous data and counts with percentages for categorical data. χ2 test or Fisher’s exact test was conducted for categorical comparisons.Results Our cohort (n=1008, median age 14 years) was predominantly black and male. During the study period, there was an overall increase in firearm injuries, driven primarily by increases in the South (S) site (β=0.11 (SE 0.02), p=<0.001) in the setting of stable rates in the West and decreasing rates in the Northeast and Mid-Atlantic sites (β=−0.15 (SE 0.04), p=0.002; β=−0.19 (SE0.04), p=0.001). Child age, race, insurance type, resource use, injury type, and shooter type all varied by regional site.Conclusion The incidence of firearm-related injuries seen at four sites during 15 years varied by site and region. The overall increase in firearm injuries was predominantly driven by the S site, where injuries were more often unintentional. This highlights the need for region-specific data to allow for the development of targeted interventions to impact the burden of injury.

【 授权许可】

CC BY-NC|CC BY|CC BY-NC-ND