Pediatric Nonpowder Firearm Injuries: Outcomes in an Urban Pediatric Setting (original) (raw)
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Firearm-Related Injuries Affecting the Pediatric Population
PEDIATRICS, 2012
This statement reaffirms the 1992 position of the American Academy of Pediatrics that the absence of guns from children's homes and communities is the most reliable and effective measure to prevent firearmrelated injuries in children and adolescents. A number of specific measures are supported to reduce the destructive effects of guns in the lives of children and adolescents, including the regulation of the manufacture, sale, purchase, ownership, and use of firearms; a ban on handguns and semiautomatic assault weapons; and expanded regulations of handguns for civilian use. In addition, this statement reviews recent data, trends, prevention, and intervention strategies of the past 5 years.
Academic emergency medicine : official journal of the Society for Academic Emergency Medicine, 2016
Firearm injuries among children are a major clinical and public health concern and one of the leading causes of pediatric fatalities. Our objective was to investigate differences in predictors and clinical outcomes between self-inflicted, violent, and unintentional pediatric firearm injuries for patients who present to pediatric emergency departments (EDs). We conducted a retrospective study of patients 0 to 21 years old treated in 37 pediatric academic EDs from 2004 to 2014. Patients were classified into the injury intent categories of self-inflicted, violent, and unintentional firearm injury using the International Classification of Diseases, 9th edition, Clinical Modification (ICD-9-CM) diagnoses and external causes of injury codes. Multivariable multinomial regression models compared groups. We identified 9,628 firearm injuries from 2004 to 2014: 109 (1%) self-inflicted, 2,394 (25%) violent, and 7,125 (74%) unintentional. Male sex, increasing age, nonwhite race, public insurance...
Trends in Firearm Injuries Among Children and Teenagers in the United States
Journal of Surgical Research, 2020
Background: Gun violence among children and teenagers in the United States occurs at a magnitude many times that of other industrialized countries. The trends of injury in this age group relative to the adult population are not well studied. This study seeks to measure trends in pediatric firearm injuries in the United States. Methods: Data from the National Trauma Data Bank (2010-2016) were used in selecting patients evaluated for firearm injury. Patients were classified as children and teenagers (<20 y) or adults (20 y). Changes in the proportion of firearm injuries among children and teenagers relative to the overall population (pediatric component) were determined using trend analyses. Results: There were 240,510 firearm injuries with children and teenagers accounting for 45,075 of these injuries (pediatric component of 18.7%). Pediatric firearm injury was mostly among males (87.4%), Blacks (60.7%), and victims of assault (76.0%). The pediatric component of firearm injuries decreased from 21.7% in 2010 to 18.2% in 2016 (P-trend < 0.001). Although there was a decrease from 22.7% to 17.6% in the pediatric component of assault (P-trend < 0.001), there was an increase from 8.7% to 10.1% in the pediatric component of self-inflicted injuries (P-trend ¼ 0.028). Substratification by race/ ethnicity showed decrease in the pediatric component of firearm injuries among all groups (P-trend < 0.001) except Whites (P-trend ¼ 0.847). Conclusions: Despite reductions in the pediatric component of firearm injuries, there remains a significant burden of injury in this group. Continued public health efforts are necessary to ensure safety and reduce firearm injuries among children and teenagers in the United States.
The American Journal of Surgery, 2020
Background: Penetrating injury independently predicts the need for surgeon presence (NSP) upon arrival. Penetrating injury is often used as a trauma triage indicator, however, it includes a wide range of specific mechanisms of injury. We sought to compare firearm-related and non-firearm related pediatric penetrating injuries with respect to NSP, ISS and mortality. Methods: Patients <18 from the 2016 National Trauma Quality Improvement Program Database were included. Penetrating injury was identified and grouped using ICD-10 mechanism codes into firearm and non-firearm related injury. NSP, ISS, and mortality were compared between the two groups. Results: A total of 1715 (4.2%) patients with penetrating injury were; 832 firearm-related and 883 nonfirearm. No deaths occurred among the non-firearm group compared to 94 (11.3%) among firearmrelated patients. Among non-firearm patients, 22.7% had a NSP indicator compared to 51.2% of patients injured by a firearm. Conclusion: There is a significantly higher proportion of severe injury and mortality with firearm penetrating injury when compared to non-firearm pediatric penetrating injury. Consideration should be given to dividing it into firearm and non-firearm penetrating injury.
International Journal of Endorsing Health Science Research
Background: Renal Trauma is one of the significant causes of deterioration, morbidity, and mortality in the pediatric age group around the globe. Firearm injuries are among one of the essential causes for renal trauma. Overall, trauma is the leading cause of death and accounts for approximately 50% of mortality in children over 1 year of age. Therefore, the current study aims to determine the frequency of morbidity, mortality and renal trauma in blunt and firearm accidents in pediatric population. Methodology: A total of 180 children, aged up to 15 years with blunt and penetrating trauma, including firearm injuries, were enrolled in our study. All patients with in the inclusion criteria of the study, who were presented in the emergency department were evaluated and resuscitated by a pediatric surgeon. Patients indicated with renal trauma were operated and were post-operatively managed in the pediatric surgery ward. All patients included were followed as an outpatient. The data of th...
Pediatric Gunshot Wounds of the Upper Extremity
International Journal of Orthopaedics
BACKGROUND: Gunshot wounds to the upper extremity in pediatric patients are an uncommon injury, but their impact on the patient can be severe. They can be accompanied by nerve damage, bone fracture, or tendon rupture. The most common cause of these pediatric gun injuries is unintentional firearm discharge. The most common type of firearm involved overall is a powdered weapon; however, non-powder weapons are a significant contributor to pediatric firearm injury. The purpose of this study is to describe the characteristics and treatment outcomes of pediatric GSW in a level one trauma center on the US-Mexican border. METHODS: Retrospective case series. RESULTS: Ten patients met our inclusion criteria for the study. The most frequent mechanism of injury was due to violence (60%), and the most frequent type of firearm involved was a powdered weapon (80%). Males were more affected than females (70%). Six patients experienced bone fracture, three patients experienced nerve damage, and one patient experienced tendon damage. No patients had lasting physical deficits as the result of their injury. CONCLUSION: Most of the pediatric GSW (60%) were due to violence. However, a significant percentage was due to accidental injury (40%). Addressing powder and non-powder weapon safety is warranted to reduce firearm injury in the pediatric population. Good outcomes can be expected in most pediatric GSW.
Toy Guns, Real Danger: an Update on Pediatric Injury Patterns Related to Non-Powder Weapons
Journal of Pediatric Surgery
Background: Design changes of nonpowder guns, including BB and air guns, have significantly increased their potential to injure. We sought to characterize the demographics of children injured with nonpowder weapons and the specific injuries suffered. Methods: A cross-sectional analysis of the study years 2006, 2009, and 2012 was performed by combining the Kids' Inpatient Database into a single dataset. We identified cases (age b 21 years) of air gun injuries using external cause of injury codes. Patient characteristics and injuries were analyzed using ICD-9 codes, and national estimates were obtained using case weighting. Results: There were 1028 pediatric admissions for nonpowder weapon related injuries. The victims were predominately male (87.0%), non-Hispanic white (52.3%), resided in the South (47.3%), and in the lowest income quartile (39.2%). Half required a major surgical procedure. The predominant injuries were open wounds to the head, neck, or trunk (40.3%), and contusion (22.5%). Notable other injuries were intracranial injury (9.1%) and blindness or vision defects (3.3%). Conclusions: The nonpowder weapons available to this generation can paralyze, blind, and cause lasting injury to children. Injuries frequently require surgical intervention, and these weapons should no longer be considered toys. Further research and legislation should be aimed at limiting children's access to these weapons. Level of evidence: III.
The American Journal of Surgery, 2017
Background: Firearm injuries have the highest case-fatality rate among pediatric trauma related deaths. We sought to determine whether demographics, mechanism of injury, and outcomes were age specific. Methods: We performed a 5 year retrospective analysis of patients 0-19 years old with firearm related injuries. Children were divided into two cohorts based on age. Mann-Whitney and Pearson's X 2 were used to compare continuous and categorical variables, respectively. Significance was established at p <0.05. Data: Compared to their younger counterparts, children >15 years old were more likely to be male (82% vs. 90%, p=0.02), African-American (71% vs 89%, p<0.0001), and injured due to assault (76.9% vs 44.6%, p<0.0001). Mortality rates for children <14 was 1.4 times the national average (10.7% vs. 7.5%) while the rate for children >15 was 3.9 times the national average (12.4% vs. 3.2%). Conclusion: Firearm injuries continue to be a prevalent public health concern greatly affecting African-American adolescent males. Prevention strategies and trauma related healthcare resource utilization should target this group in order to reduce the risk of injury and improve outcomes and case-fatality in our population.