Guns, scalpels, and sutures: The cost of gunshot wounds in children and adolescents

Phillips, Ryan; Shahi, Niti; Bensard, Denis D.; Meier, Maxene; Shirek, Gabrielle; Goldsmith, Adam; Recicar, John; Haasz, Maya; Schroeppel, Thomas J.; Moulton, Steven L.

doi:10.1097/ta.0000000000002766

Cited by 20 publications

(28 citation statements)

References 22 publications

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“…According to this analysis, the average annual billed charges for GSW cases is ~$3,800,000,000. This number is similar to those from earlier projections 31,32 . However, only GSW‐related injuries coded as initial encounter were used for this analysis, whereas all subsequent visits or and encounters related to sequela from visits were excluded.…”

Section: Discussionmentioning

confidence: 99%

Blood transfusions in gunshot‐wound‐related emergency department visits and hospitalizations in the United States

et al. 2021

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Background The United States (US) leads all high‐income countries in gunshot wound (GSW) deaths. However, previous US studies have not evaluated the national blood transfusion utilization patterns in hospitalized GSW patients. Methods Data from 2016 to 2017 were analyzed from the Nationwide Emergency Department Sample (NEDS) and Nationwide Inpatient Sample (NIS), the largest all‐payer emergency department (ED) and inpatient databases, respectively. Using stratified probability sampling, weights were applied to generate nationally representative estimates. Multivariable Poisson‐regression models were used to estimate prevalence ratios (PR) of blood transfusion. Results There were 168,315 ED visits and 58,815 hospitalizations (age = 18–90 years) following a GSW. The majority of hospitalizations were men (88.5%), age 18–24 years (31.8%), and assault‐related GSW (51.3%). Blacks had the largest proportion (48.7%) overall of all GSW hospitalizations; Whites accounted for the highest proportion of intentional self‐harm injuries (72.4%). Blood transfusions occurred in 12.7% of hospitalizations (12.0% red blood cell [RBC], 4.9% plasma, and 2.5% platelet transfusions). Only 1.9% of cases were associated with transfusion of all three blood components. Hospitalizations with major/extreme severity of illness had significantly higher prevalence of transfusion versus those with mild/moderate severity [crude PR = 4.79 (95%CI:4.15–5.33, p < .001)]. Overall, 8.2% of hospitalizations with GSW died, of whom 26.8% required blood transfusions, which was significantly higher than survivors [crude PR = 2.34 (95%CI:2.10–2.61, p < .001)]. The vast majority (95%) of the transfusions among those who died were within 48 h since admission. Conclusions Gun‐related violence is a public health emergency in the US, and GSWs are a source of significant mortality, blood utilization, and health care costs.

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Section: Discussionmentioning

confidence: 99%

Blood transfusions in gunshot‐wound‐related emergency department visits and hospitalizations in the United States

et al. 2021

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“…Data from the National Trauma Data Bank underscore the magnitude of this disparity, with a case fatality rate (CFR) for gunshot wounds (GSWs) nearly four times that of motor vehicle collisions (MVCs) [2,3]. Pediatric GSWs are resource intensive with high rates of operative intervention and significant costs to the healthcare system, [4].…”

Section: Introductionmentioning

confidence: 99%

The hidden mortality of pediatric firearm violence

Theodorou

Beyer

Vanover

et al. 2022

Journal of Pediatric Surgery

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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“…Colarado eyaletinde 10 yıl boyunca ateşli silah yaralanmasına maruz kalan pediatri vakalarını yaşa göre çocuk (0-14 yıl) ve adolesan (15-18 yıl) alt gruplarında inceleyen bir çalışmada, çocuk alt grubunda en sık yaralanma nedeninin kaza (%61,1), ikinci sırada ise saldırı (%29,4) olduğu bildirilmiş, en sık hasar gören bölge açısından bu alt grupta batın yaralanmaları (%15,1), kafa (%46,0) ve alt ekstremitenin (%24,6) ardından üçüncü sırada yer almıştır. Adolesan alt grubunda ise yaralanma nedeni %83,5 vakada saldırı olarak tanımlanmış, batın yaralanmaları (%22,0) ise alt ekstremitenin (%29,7) ardından en sık hasar gören ikinci anatomik bölge olmuştur (8). Alabama eyaletinde 1999-2010 yılları arasında 0-19 yaş grubunda ateşli silah yaralanmalarının incelendiği tek merkezli bir diğer çalışmada ise batın yaralanmalarının (%20,1) ekstremite (%43,8) ve kafa (%28,4) yaralanmaları ardından üçüncü sırada geldiği bildirilmiştir (9).…”

Section: Introductionunclassified

Clinical Characteristics of Child Patients Operated for Abdominal Gunshot Injury: A Somali Experience

KÜÇÜK

Abdi

Mohamed

et al. 2022

Sağlık Bilimlerinde Değer

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Ateşli silah yaralanmaları dünya genelinde önemli bir morbidite ve mortalite nedenidir. Bu çalışmada Somali'deki tek çocuk cerrahisi kliniğinde abdominal ateşli silah yaralanması nedeniyle opere edilen hastaların klinik özellikleri incelendi. Gereç ve Yöntemler: Bu çalışmada,Somali'deki tek çocuk cerrahisi kliniğine Mayıs 2019 -Temmuz 2021 tarihleri arasında abdominal ateşli silah yaralanması ile getirilen ve opere edilen 42 çocuk hastanınkayıtları retrospektif olarak incelendi. Hastalar yaş, cinsiyet, yaralanma nedeni (ateşli silah veya bombalanma), tedavi, ameliyat bulguları, yaralanan organlar, hastanede kalış süresi ve komplikasyonlar açısından değerlendirildi. Bulgular: Yaşları 3 -16 arasında değişen (ortanca 10 yıl), 28 (%67) erkek ve 14 (%33) kadın hastaların 30'u (%71) bombalanma, 12'si ise (%29) kurşunlanma sonucu yaralanmıştı. Vakaların 21'inde (%50) tek, 21'inde (%50) birden fazla organ yaralanması saptandı. En sık hasar gören organlar sırasıyla ince bağırsak (n=24), kolon (n=14), karaciğer (n=10) ve böbrekti (n=7). Ortanca yatış süresi yedi gün olarak saptandı. Vakaların 36'sı (%86) serviste, altısı (%14) yoğun bakım ünitesinde takip edildi. Yoğun bakımda takip edilen iki hastanın seyri mortalite ile sonuçlandı. Sonuç: Çalışmamızın sonuçları, Somali'de tek bir çocuk cerrahisi kliniğinde kısa bir zaman dilimi içinde elde ettiğimiz verilerin, çocukların ciddi oranda abdominal ateşli silah yaralanmalarına maruz kaldıklarını ve önemli bir morbidite ve mortalite ile karşı karşıya olduklarını ortaya koymaktadır.

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Guns, scalpels, and sutures: The cost of gunshot wounds in children and adolescents

Cited by 20 publications

References 22 publications

Blood transfusions in gunshot‐wound‐related emergency department visits and hospitalizations in the United States

Blood transfusions in gunshot‐wound‐related emergency department visits and hospitalizations in the United States

The hidden mortality of pediatric firearm violence

Clinical Characteristics of Child Patients Operated for Abdominal Gunshot Injury: A Somali Experience

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