Variability in firearm injury among major pediatric trauma centers across the USA
ObjectivesIn 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...
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| Published in | Trauma surgery & acute care open Vol. 8; no. 1; p. e001014 |
|---|---|
| Main Authors | , , , , , , , , , , , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
England
BMJ Publishing Group Ltd
30.05.2023
BMJ Publishing Group LTD BMJ Publishing Group |
| Subjects | |
| Online Access | Get full text |
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| Abstract | ObjectivesIn 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.MethodsWe 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.ResultsOur 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.ConclusionThe 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.Level of Evidence: II, retrospective study |
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| AbstractList | ObjectivesIn 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. MethodsWe 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. ResultsOur 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. ConclusionThe 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.Level of Evidence: II, retrospective study. ObjectivesIn 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.MethodsWe 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.ResultsOur 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.ConclusionThe 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.Level of Evidence: II, retrospective study 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. 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. χ test or Fisher's exact test was conducted for categorical comparisons. 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. 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.Level of Evidence: II, retrospective study. 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.Level of Evidence: II, retrospective study |
| Author | Sheline, Erica Morris, Claudia R Simon, Harold K Nance, Michael Feng, Alayna Chun, Thomas Ruest, Stephanie M Khan, Naghma Myers, Sage Russell, Katherine Grupp-Phelan, Jacqueline Feske-Kirby, Katherine Kanaan, Ghid Cooper, Nicholas Chaudhary, Sofia Gutman, Colleen K McGlamry, Katherine Figueroa, Janet Shaahinfar, Ashkon Fein, Joel Fraser Doh, Kiesha Keathley, Nora Rowker, Kelli |
| AuthorAffiliation | 7 Hasbro Children's Hospital , Providence , Rhode Island , USA 19 University of Colorado Denver School of Medicine , Aurora , Colorado , USA 1 Department of Pediatrics and Emergency Medicine, Emory University School of Medicine , Atlanta , Georgia , USA 9 University of Pennsylvania Perelman School of Medicine , Philadelphia , Pennsylvania , USA 16 Imagen , Manhattan , New York , USA 17 Northside Pediatrics , Atlanta , Georgia , USA 6 Department of Emergency Medicine and Pediatrics , Brown University Warren Alpert Medical School , Providence , Rhode Island , USA 14 University of Florida College of Medicine , Gainesville , Florida , USA 11 Donald and Barbara Zucker School of Medicine at Hofstra/Northwell , Hempstead , New York , USA 4 Department of Emergency Medicine , Hasbro Children's Hospital , Providence , Rhode Island , USA 5 Departments of Emergency Medicine and Pediatrics , University of California San Francisco , San Francisco , California , USA 8 SUNY Upstate Medical University Hospital , |
| AuthorAffiliation_xml | – name: 2 Children's Healthcare of Atlanta Inc , Atlanta , Georgia , USA – name: 4 Department of Emergency Medicine , Hasbro Children's Hospital , Providence , Rhode Island , USA – name: 3 Department of Emergency Medicine , Brown University , Providence , Rhode Island , USA – name: 16 Imagen , Manhattan , New York , USA – name: 9 University of Pennsylvania Perelman School of Medicine , Philadelphia , Pennsylvania , USA – name: 10 Division of Emergency Medicine and Center for Violence Prevention , The Children's Hospital of Philadelphia , Philadelphia , Pennsylvania , USA – name: 14 University of Florida College of Medicine , Gainesville , Florida , USA – name: 5 Departments of Emergency Medicine and Pediatrics , University of California San Francisco , San Francisco , California , USA – name: 6 Department of Emergency Medicine and Pediatrics , Brown University Warren Alpert Medical School , Providence , Rhode Island , USA – name: 15 University of California San Francisco , San Francisco , California , USA – name: 8 SUNY Upstate Medical University Hospital , Syracuse , New York , USA – name: 11 Donald and Barbara Zucker School of Medicine at Hofstra/Northwell , Hempstead , New York , USA – name: 7 Hasbro Children's Hospital , Providence , Rhode Island , USA – name: 13 Department of Pediatrics , Emory University , Atlanta , Ga , USA – name: 19 University of Colorado Denver School of Medicine , Aurora , Colorado , USA – name: 20 Children's Hospital Colorado , Aurora , Colorado , USA – name: 12 The Children's Hospital of Philadelphia , Philadelphia , Pennsylvania , USA – name: 17 Northside Pediatrics , Atlanta , Georgia , USA – name: 1 Department of Pediatrics and Emergency Medicine, Emory University School of Medicine , Atlanta , Georgia , USA – name: 18 Rollins School of Public Health , Atlanta , Georgia , USA |
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| Keywords | Wounds, Gunshot pediatrics Firearms |
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| Snippet | ObjectivesIn 2020, firearm injuries surpassed automobile collisions as the leading cause of death in US children. Annual automobile fatalities have decreased... In 2020, firearm injuries surpassed automobile collisions as the leading cause of death in US children. Annual automobile fatalities have decreased during 40... Objectives In 2020, firearm injuries surpassed automobile collisions as the leading cause of death in US children. Annual automobile fatalities have decreased... |
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| SubjectTerms | Age Data collection Demographics Electronic health records Emergency medical care Firearms Hospital systems Hospitals Injuries Medicaid Medical records Murders & murder attempts Original Research Patients Pediatrics Public health Trauma Trauma centers Violence Wounds, Gunshot |
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| Title | Variability in firearm injury among major pediatric trauma centers across the USA |
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