Firearm Injuries Due to Legal Intervention in Children and Adolescents: A National Analysis

• Published in: The Journal of surgical research Vol. 214; pp. 140 - 144
• Main Authors: Joudi, Noor, BS, Tashiro, Jun, MD MPH, Golpanian, Samuel, MD, Eidelson, Sarah A., MD, Perez, Eduardo A., MD, Sola, Juan E., MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 15.06.2017
• Subjects: Adolescent; Child; Child, Preschool; Databases, Factual; Female; Firearms; Firearms - legislation & jurisprudence; Gunshot; Hospitalization; Humans; Incidence; Infant; Infant, Newborn; Law Enforcement; Legislation; Male; Police - legislation & jurisprudence; Police - statistics & numerical data; Retrospective Studies; Surgery; United States - epidemiology; Violence; Violence - ethnology; Violence - legislation & jurisprudence; Violence - statistics & numerical data; Wounds; Wounds, Gunshot - epidemiology; Wounds, Gunshot - etiology; Young Adult; wounds; gunshot; firearms; legislation; violence; Wounds; Firearms; Violence; Legislation; Gunshot
• ISSN: 0022-4804; 1095-8673
• DOI: 10.1016/j.jss.2017.03.007

Introduction Firearm injuries related to legal intervention have come under scrutiny due to recent events. Methods The Kids’ Inpatient Database (1997-2012) was searched for firearm injuries due to legal interventions (ICD-9-CM E970) requiring inpatient admission in children <20 years of age. Cases were weighted to provide national estimates. The Brady Campaign Criteria were used to identify lenient vs. strict gun law states. Results Overall, 275 cases were identified, with a 7.5% mortality rate. Incidence peaked at 1.0 per 100,000 admissions in 2006, significantly increased from a low 0.2 per 100,000 admissions in 1997, p<0.001. Patients were predominantly male (97%). African Americans (44%) represented the largest racial group, followed by Hispanics (30%) and Caucasians (20%). Mean age was 17.5±2.08 years. Patients were insured by Medicaid (33%) or a private payer (24%); the remainder (43%) were uninsured. Admissions most frequently occurred at urban teaching hospitals (81%). Cases occurred most frequently in the Southern U.S. (44%), followed by the Western U.S. (35%). Most patients presented to non-children’s hospitals (97%). Mean hospital admission cost was 27,507±40,197 USD, whereas mean charges amounted to 75,905±116,622 USD. Cases mostly occurred in lenient (56%) gun law states, whereas the remainder occurred in strict (41%) and neutral (3%) states. When analyzed by race, Caucasians (16%) had a significantly higher mortality rate when compared to African Americans (5%), p=0.03. Conclusion An analysis of this very specific injury mechanism demonstrates important findings, which are difficult to collect from conventional data sources. Future research will contribute to the objective analysis of this politically charged subject.