Pediatric firearm injury related emergency department visits and hospitalizations: a population-based study in the United StatesResearch in context
Summary: Background: Firearm injury (FI) is the leading cause of death in children and adolescents in the United States (US). We describe the epidemiology of pediatric FI-associated emergency department (ED) visits and hospitalizations in the US stratified by race and ethnicity. Methods: Data on pe...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-06-01
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| Series: | The Lancet Regional Health. Americas |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2667193X23000777 |
| _version_ | 1797832688991731712 |
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| author | Ruchika Goel Xianming Zhu Sarah Makhani Cassandra D. Josephson Jodie L. White Oliver Karam Marianne E. Nellis Eric A. Gehrie Mingmar Sherpa Elizabeth P. Crowe Evan M. Bloch Aaron A.R. Tobian |
| author_facet | Ruchika Goel Xianming Zhu Sarah Makhani Cassandra D. Josephson Jodie L. White Oliver Karam Marianne E. Nellis Eric A. Gehrie Mingmar Sherpa Elizabeth P. Crowe Evan M. Bloch Aaron A.R. Tobian |
| author_sort | Ruchika Goel |
| collection | DOAJ |
| description | Summary: Background: Firearm injury (FI) is the leading cause of death in children and adolescents in the United States (US). We describe the epidemiology of pediatric FI-associated emergency department (ED) visits and hospitalizations in the US stratified by race and ethnicity. Methods: Data on pediatric (0–17-year-olds) FI were analyzed using the 2019 Nationwide Emergency Department Sample (NEDS) and Kids’ Inpatient Database (KID), the largest all-payer databases in the US for ED visits and pediatric hospitalizations, respectively. FI encounters were stratified by race and ethnicity. Poisson regression was used to identify factors associated with in-hospital mortality. Sampling weights were applied to generate nationally representative estimates. Findings: There were 7017 pediatric ED visits with FI (NEDS); 85.0% (5961/7017) were male and 73.0% (5125/7017) were adolescents (15–17 years). Overall, 5.5% (384/7017) died in the ED; 53.1% (3727/7017) of ED encounters did not result in hospitalization. There were 2817 pediatric FI hospitalizations (KID); 84.1% (2369/2817) were male and 71.6% (2018/2817) were adolescents; 51.4% (1447/2817) of FI were unintentional, 42.8% (1207/2817) were assault-related, and 5.8% (163/2817) were self-inflicted. Black children had the highest proportion (52.6%; 1481/2817) of hospitalizations among all race and ethnicities (p < 0.0001 vs. White). White children had the highest proportion of hospitalizations for self-inflicted injuries (16.6% [91/551] vs. 4.9% [25/504; p < 0.0001] in Hispanics and 1.7% [24/1481] in Blacks; p < 0.0001). The majority (56.5%; 1591/2817) of hospitalizations were patients from low-income zip codes (median annual-household-income <$44,000); 70% (1971/2817) had Medicaid as the primary insurance payer. Overall, 8.0% (225/2817) died during FI-associated hospitalizations. Self-inflicted injuries had the highest in-hospital mortality (prevalence ratio = 8.20, 95% CI = 6.06–11.10 vs. unintentional). Interpretation: Black children and children with lower household incomes were disproportionately impacted by FI resulting from assaults and accidents, while White children had the highest proportion of self-inflicted FI injuries. Public health and legal policy interventions are needed to prevent pediatric FI. Funding: US National Institutes of Health. |
| first_indexed | 2024-04-09T14:11:51Z |
| format | Article |
| id | doaj.art-44c351c3e8984d0a96a1f3d48a1e1c71 |
| institution | Directory Open Access Journal |
| issn | 2667-193X |
| language | English |
| last_indexed | 2024-04-09T14:11:51Z |
| publishDate | 2023-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | The Lancet Regional Health. Americas |
| spelling | doaj.art-44c351c3e8984d0a96a1f3d48a1e1c712023-05-06T04:39:24ZengElsevierThe Lancet Regional Health. Americas2667-193X2023-06-0122100503Pediatric firearm injury related emergency department visits and hospitalizations: a population-based study in the United StatesResearch in contextRuchika Goel0Xianming Zhu1Sarah Makhani2Cassandra D. Josephson3Jodie L. White4Oliver Karam5Marianne E. Nellis6Eric A. Gehrie7Mingmar Sherpa8Elizabeth P. Crowe9Evan M. Bloch10Aaron A.R. Tobian11Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Simmons Cancer Institute at SIU School of Medicine, Springfield, IL, USADepartment of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USADepartment of Medicine, New York University Grossman School of Medicine, New York, NY, USADepartment of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Pathology, Johns Hopkins All Children's Hospital, St. Petersburg, FL, USADepartment of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USADepartment of Pediatrics, Yale School of Medicine, New Haven, CT, USADepartment of Pediatrics, Weill Cornell Medicine, New York, NY, USAAmerican Red Cross, Biomedical Services Division, National Headquarters, Washington, DC, USAVitalant, Chicago, IL, USADepartment of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USADepartment of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USADepartment of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Corresponding author. Department of Pathology, School of Medicine, Johns Hopkins University, Carnegie 437, 600 N. Wolfe St, Baltimore, MD, 21287, USA.Summary: Background: Firearm injury (FI) is the leading cause of death in children and adolescents in the United States (US). We describe the epidemiology of pediatric FI-associated emergency department (ED) visits and hospitalizations in the US stratified by race and ethnicity. Methods: Data on pediatric (0–17-year-olds) FI were analyzed using the 2019 Nationwide Emergency Department Sample (NEDS) and Kids’ Inpatient Database (KID), the largest all-payer databases in the US for ED visits and pediatric hospitalizations, respectively. FI encounters were stratified by race and ethnicity. Poisson regression was used to identify factors associated with in-hospital mortality. Sampling weights were applied to generate nationally representative estimates. Findings: There were 7017 pediatric ED visits with FI (NEDS); 85.0% (5961/7017) were male and 73.0% (5125/7017) were adolescents (15–17 years). Overall, 5.5% (384/7017) died in the ED; 53.1% (3727/7017) of ED encounters did not result in hospitalization. There were 2817 pediatric FI hospitalizations (KID); 84.1% (2369/2817) were male and 71.6% (2018/2817) were adolescents; 51.4% (1447/2817) of FI were unintentional, 42.8% (1207/2817) were assault-related, and 5.8% (163/2817) were self-inflicted. Black children had the highest proportion (52.6%; 1481/2817) of hospitalizations among all race and ethnicities (p < 0.0001 vs. White). White children had the highest proportion of hospitalizations for self-inflicted injuries (16.6% [91/551] vs. 4.9% [25/504; p < 0.0001] in Hispanics and 1.7% [24/1481] in Blacks; p < 0.0001). The majority (56.5%; 1591/2817) of hospitalizations were patients from low-income zip codes (median annual-household-income <$44,000); 70% (1971/2817) had Medicaid as the primary insurance payer. Overall, 8.0% (225/2817) died during FI-associated hospitalizations. Self-inflicted injuries had the highest in-hospital mortality (prevalence ratio = 8.20, 95% CI = 6.06–11.10 vs. unintentional). Interpretation: Black children and children with lower household incomes were disproportionately impacted by FI resulting from assaults and accidents, while White children had the highest proportion of self-inflicted FI injuries. Public health and legal policy interventions are needed to prevent pediatric FI. Funding: US National Institutes of Health.http://www.sciencedirect.com/science/article/pii/S2667193X23000777Firearm injuryGunshot woundChildrenEmergency departmentEmergency roomED |
| spellingShingle | Ruchika Goel Xianming Zhu Sarah Makhani Cassandra D. Josephson Jodie L. White Oliver Karam Marianne E. Nellis Eric A. Gehrie Mingmar Sherpa Elizabeth P. Crowe Evan M. Bloch Aaron A.R. Tobian Pediatric firearm injury related emergency department visits and hospitalizations: a population-based study in the United StatesResearch in context The Lancet Regional Health. Americas Firearm injury Gunshot wound Children Emergency department Emergency room ED |
| title | Pediatric firearm injury related emergency department visits and hospitalizations: a population-based study in the United StatesResearch in context |
| title_full | Pediatric firearm injury related emergency department visits and hospitalizations: a population-based study in the United StatesResearch in context |
| title_fullStr | Pediatric firearm injury related emergency department visits and hospitalizations: a population-based study in the United StatesResearch in context |
| title_full_unstemmed | Pediatric firearm injury related emergency department visits and hospitalizations: a population-based study in the United StatesResearch in context |
| title_short | Pediatric firearm injury related emergency department visits and hospitalizations: a population-based study in the United StatesResearch in context |
| title_sort | pediatric firearm injury related emergency department visits and hospitalizations a population based study in the united statesresearch in context |
| topic | Firearm injury Gunshot wound Children Emergency department Emergency room ED |
| url | http://www.sciencedirect.com/science/article/pii/S2667193X23000777 |
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