Variability in firearm injury among major pediatric trauma centers across the USA
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, ther...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2023-11-01
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| Series: | Trauma Surgery & Acute Care Open |
| Online Access: | https://tsaco.bmj.com/content/8/1/e001014.full |
| _version_ | 1797367494900449280 |
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| author | Katherine Russell Katherine Feske-Kirby Joel Fein Claudia R Morris Michael Nance Nicholas Cooper Sofia Chaudhary Stephanie M Ruest Colleen K Gutman Kiesha Fraser Doh Ashkon Shaahinfar Thomas Chun Alayna Feng Janet Figueroa Jacqueline Grupp-Phelan Ghid Kanaan Nora Keathley Naghma Khan Katherine McGlamry Sage Myers Kelli Rowker Erica Sheline Harold K Simon |
| author_facet | Katherine Russell Katherine Feske-Kirby Joel Fein Claudia R Morris Michael Nance Nicholas Cooper Sofia Chaudhary Stephanie M Ruest Colleen K Gutman Kiesha Fraser Doh Ashkon Shaahinfar Thomas Chun Alayna Feng Janet Figueroa Jacqueline Grupp-Phelan Ghid Kanaan Nora Keathley Naghma Khan Katherine McGlamry Sage Myers Kelli Rowker Erica Sheline Harold K Simon |
| author_sort | Katherine Russell |
| collection | DOAJ |
| description | 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 |
| first_indexed | 2024-03-08T17:19:08Z |
| format | Article |
| id | doaj.art-b59910d39ed8494bbc5a46e73d874491 |
| institution | Directory Open Access Journal |
| issn | 2397-5776 |
| language | English |
| last_indexed | 2024-03-08T17:19:08Z |
| publishDate | 2023-11-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | Trauma Surgery & Acute Care Open |
| spelling | doaj.art-b59910d39ed8494bbc5a46e73d8744912024-01-03T10:05:08ZengBMJ Publishing GroupTrauma Surgery & Acute Care Open2397-57762023-11-018110.1136/tsaco-2022-001014Variability in firearm injury among major pediatric trauma centers across the USAKatherine Russell0Katherine Feske-Kirby1Joel Fein2Claudia R Morris3Michael Nance4Nicholas Cooper5Sofia Chaudhary6Stephanie M Ruest7Colleen K Gutman8Kiesha Fraser Doh9Ashkon Shaahinfar10Thomas Chun11Alayna Feng12Janet Figueroa13Jacqueline Grupp-Phelan14Ghid Kanaan15Nora Keathley16Naghma Khan17Katherine McGlamry18Sage Myers19Kelli Rowker20Erica Sheline21Harold K Simon22Rollins School of Public Health, Atlanta, Georgia, USAThe Children`s Hospital of Philadelphia, Philadelphia, Pennsylvania, USAUniversity of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USADepartment of Pediatrics, Division of Pediatric Emergency Medicine, Emory University School of Medicine, Children`s Healthcare of Atlanta, Atlanta, Georgia, USAUniversity of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USASUNY Upstate Medical University Hospital, Syracuse, New York, USADepartment of Pediatrics and Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia, USADepartment of Emergency Medicine, Brown University, Providence, Rhode Island, USAUniversity of Florida College of Medicine, Gainesville, Florida, USADepartment of Pediatrics and Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia, USADepartments of Emergency Medicine and Pediatrics, University of California San Francisco, San Francisco, California, USADepartment of Emergency Medicine and Pediatrics, Brown University Warren Alpert Medical School, Providence, Rhode Island, USADonald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USADepartment of Pediatrics, Emory University, Atlanta, Ga, USAUniversity of California San Francisco, San Francisco, California, USAHasbro Children`s Hospital, Providence, Rhode Island, USAImagen, Manhattan, New York, USADepartment of Pediatrics and Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia, USANorthside Pediatrics, Atlanta, Georgia, USAUniversity of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USAChildren`s Healthcare of Atlanta Inc, Atlanta, Georgia, USAUniversity of Colorado Denver School of Medicine, Aurora, Colorado, USADepartment of Pediatrics and Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia, USAObjectives 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 studyhttps://tsaco.bmj.com/content/8/1/e001014.full |
| spellingShingle | Katherine Russell Katherine Feske-Kirby Joel Fein Claudia R Morris Michael Nance Nicholas Cooper Sofia Chaudhary Stephanie M Ruest Colleen K Gutman Kiesha Fraser Doh Ashkon Shaahinfar Thomas Chun Alayna Feng Janet Figueroa Jacqueline Grupp-Phelan Ghid Kanaan Nora Keathley Naghma Khan Katherine McGlamry Sage Myers Kelli Rowker Erica Sheline Harold K Simon Variability in firearm injury among major pediatric trauma centers across the USA Trauma Surgery & Acute Care Open |
| title | Variability in firearm injury among major pediatric trauma centers across the USA |
| title_full | Variability in firearm injury among major pediatric trauma centers across the USA |
| title_fullStr | Variability in firearm injury among major pediatric trauma centers across the USA |
| title_full_unstemmed | Variability in firearm injury among major pediatric trauma centers across the USA |
| title_short | Variability in firearm injury among major pediatric trauma centers across the USA |
| title_sort | variability in firearm injury among major pediatric trauma centers across the usa |
| url | https://tsaco.bmj.com/content/8/1/e001014.full |
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