A 6-year retrospective review of pediatric firearm injuries

Hendry, Phyllis L.; Suen, Andrea; Kalynych, Colleen; Lott, Michelle; Paul, Julia; Smotherman, Carmen

doi:10.1097/ta.0000000000000384

Cited by 14 publications

(4 citation statements)

References 10 publications

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“…Another study using administrative emergency department data, reported that most frequently documented firearm injuries were assaults followed by unintentional injuries among those children who were B18 years old [2]. This reversal maybe due to the inclusion of pediatric FH below 16 years, and can be rationalized by the distinct firearm injury differences between children (\16 years) and adolescents [9]. Unlike the experience of the pediatric FHs in our study, national cumulative FHs were mostly due to assault intent, where majority were adults [10].…”

Section: Discussionmentioning

confidence: 90%

“…Both assault and unintentional injuries have been implicated as leading causes of FH depending on the age of the children [12,17]. Recent evidence suggests that the declining trend in firearm fatalities was attributed to decline in firearm homicide rates among those aged 15-19 years [6], and that FHs among those \15 years have different risk profiles as compared to older children [9]. The difference in firearm injury by race is associated with the intent of injury, where white children were injured after unintentional firearm discharge, whereas most black children were shot violently [17].…”

Section: Introductionmentioning

confidence: 97%

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Racial/Ethnic Specific Trends in Pediatric Firearm-Related Hospitalizations in the United States, 1998–2011

Kalesan

Dabic

Vasan

et al. 2015

Matern Child Health J

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Section: Discussionmentioning

confidence: 90%

Section: Introductionmentioning

confidence: 97%

Racial/Ethnic Specific Trends in Pediatric Firearm-Related Hospitalizations in the United States, 1998–2011

Kalesan

Dabic

Vasan

et al. 2015

Matern Child Health J

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“…Recent epidemiological research 14,16,17,33 has focused on defining the incidence and trends in firearm-related injuries among children to better understand the characteristics of such injuries and to inform injury prevention efforts. Our multisite study adds to the literature as it is one of the largest studies to date to describe the characteristics of children with firearm injuries, especially those sustaining non-fatal firearm injuries, and it is the first to examine the relative influence of individual and neighborhood factors on firearm injury risk among a cohort of children seeking ED care.…”

Section: Discussionmentioning

confidence: 99%

Individual and Neighborhood Characteristics of Children Seeking Emergency Department Care for Firearm Injuries Within the PECARN Network

Carter

Cook

Macy

et al. 2017

Academic Emergency Medicine

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Objective To describe the characteristics of children seeking emergency care for firearm injuries within the PECARN network, and assess the influence of both individual and neighborhood factors on firearm-related injury risk. Methods This was a retrospective, multicenter cross-sectional analysis of children (<19-years-old) presenting to 16 pediatric EDs (2004–2008). ICD-9-CM E-codes were used to identify and categorize firearm injuries by mechanism/intent. Neighborhood variables were derived from home address data. Multivariable analysis examined the influence of individual and neighborhood factors on firearm-related injuries as compared to non-firearm ED visits. Injury recidivism was assessed. Results 1,758 pediatric ED visits for firearm-related injuries were analyzed. Assault (51.4%, n=904) and unintentional injury (33.2%, n=584) were the most common injury mechanisms. Among children with firearm injuries, 68.3% were older adolescents (15–19 years-old), 82.3% male, 68.2% African-American, and 76.3% received public insurance/were uninsured. Extremity injuries were most common (75.9%), with 20% sustaining injuries to multiple body regions, 48.1% requiring admission, and 1% ED mortality. Multivariable analysis identified firearm injury risk factors, including adolescent age (p<0.001), male gender (p<0.001), non-Caucasian race/ethnicity (p<0.001), public payer/uninsured status (p<0.001), and higher levels of neighborhood disadvantage (p<0.001). Among children with firearm injuries, 12-month ED recidivism for any reason was 22.4%, with <1% returning for another firearm injury. Conclusion Among children receiving ED treatment within the PECARN network, there are distinct demographic and neighborhood factors associated with firearm injuries. Among younger children (<10 years old), unintentional injuries predominate, while assault-type injuries were most common among older adolescents. Overall, among this PECARN patient population, male adolescents living in neighborhoods characterized by high-levels of concentrated disadvantage had an elevated risk for firearm injury. Public health efforts should focus on developing and implementing initiatives addressing risk factors at both the individual and community level, including ED-based interventions to reduce the risk for firearm injuries among high-risk pediatric populations.

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“…Younger adults between the age of 16 and 45 years hospitalized for firearm injury were more likely to be injured by assault 7 11 as compared with older adults who are hospitalized for self-inflicted injuries. 12 Older youth between 16–19 years of age had firearm injury profile similar to that of adults, 13 particularly with respect to firearm homicide rates.…”

Section: Introductionmentioning

confidence: 97%

A multi-decade joinpoint analysis of firearm injury severity

Kalesan

Zuo

Xuan

et al. 2018

Trauma Surg Acute Care Open

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BackgroundNon-fatal firearm injuries constitute approximately 70% of all firearm trauma injuries in the United States. Patterns of severity of these injuries are poorly understood. We analyzed the overall, age-, sex- and intent-specific temporal trends in the injury severity of firearm hospitalizations from 1993 to 2014.MethodsWe assessed temporal trends in the severity of patients hospitalized for firearm using Nationwide Inpatient Sample (NIS) data over a 22 year period. Firearm hospitalization was identified using assault (E965x), unintentional (E922x), intentional self-harm (E955x), legal (E970) and undetermined (E985x) International Classification of Diseases, Ninth Revision, Clinical Modification (ICD9) codes. Injury severity was measured using the computed New Injury Severity Score (NISS). We used survey weighted means, SD and annual percent change (APC), and joinpoint regression to analyze temporal trends.ResultsA weighted total of 648 662 inpatient admissions for firearm injury were analyzed. Firearm injury severity demonstrated a significant annual increase of 1.4% (95% CI=1.3 to 1.6), and was driven by annual increases among young adults (APC=1.4%, 95% CI=1.3 to 1.5), older adults (APC=1.5%, 95% CI=1.3 to 1.6), female (APC=1.5%, 95% CI=1.3 to 1.6) and male (APC=1.4%, 95% CI=1.3 to 1.6) hospitalizations. The annual increase among assault/legal injuries was 1.4% (95% CI=1.3 to 1.5), similar to unintentional (APC=1.4%, 95% CI=1.3 to 1.6), intentional self-harm (APC=1.5%, 95% CI=1.4 to 1.6) and undetermined (APC=1.4%, 95% CI=1.3 to 1.6).ConclusionsThe severity of hospitalized firearm injuries increased significantly from 1993 to 2014. This annual increase reflects a move towards hospitalization of more serious injuries, and outpatient management of less serious injuries across the board, suggesting a mounting burden on the US healthcare system.Level of evidenceLevel IV.

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A 6-year retrospective review of pediatric firearm injuries

Cited by 14 publications

References 10 publications

Racial/Ethnic Specific Trends in Pediatric Firearm-Related Hospitalizations in the United States, 1998–2011

Racial/Ethnic Specific Trends in Pediatric Firearm-Related Hospitalizations in the United States, 1998–2011

Individual and Neighborhood Characteristics of Children Seeking Emergency Department Care for Firearm Injuries Within the PECARN Network

A multi-decade joinpoint analysis of firearm injury severity

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