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

Posted on January 26, 2017

A. E. Wagenaar1, J. Tashiro1, N. Joudi1, E. A. Perez1, J. E. Sola1  1University Of Miami,Surgery,Miami, FL, USA

Introduction:  Firearm injuries related to legal intervention have come under scrutiny due to recent events. We sought to analyze this rare event using a large, population based database.

Methods:  The Kids’ Inpatient Database (1997-2012) was searched for firearm injuries due to legal interventions (ICD-9-CM code 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, a total of 275 cases were identified during the study period, with a 7.5% mortality rate. Case incidence reached a peak 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 most frequently insured by Medicaid (33%) or a private payer (24%), whereas the remainder (22%) were uninsured.

Hospital 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 ± 40197 USD, whereas mean charges amounted to 75905 ± 116622 USD. Cases of intervention 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 help in contributing to the objective analysis of this politically charged subject.