O. A. Olufajo1, A. Zeineddin1, E. De La Cruz1, M. Williams1, E. Cornwell1 1Howard University College Of Medicine,Department Of Surgery,Washington, DC, USA
Introduction: Gunshot violence in the United States occurs at a magnitude that has drawn increasing national attention. Children and teenagers form a vulnerable group who are often victims of firearm injury. Although there are targeted efforts to reduce firearm injuries in children and teenagers, the national trends of injury in this age-group relative to the adult population is not well studied. This study seeks to measure trends in firearm injuries evaluated in US hospitals comparing children and teenagers to adult victims.
Methods: Data from the National Trauma Data Bank (2010-2015) was used in selecting patients evaluated for firearm injury. Based on their age at presentation, patients were classified as children and teenagers (< 20 years old) or adults (≥ 20 years old). Using International Classification of Disease, 9th Edition, Clinical Modification, external cause of injury codes, firearm injuries were categorized as assault, self-inflicted, unintentional or undetermined. Changes in the proportion of firearm injuries among children and adolescents relative to the overall population was determined using trend analyses. Patients were sub-stratified by race/ethnicity and by insurance type to evaluate differences in trends by socioeconomic factors.
Results: There were 37709 children and teenagers (18.9%) and 162282 adults (81.1%) in the study cohort. Compared to adults who had firearm injuries, children and teenagers were more likely to be Black (61.1% vs 52.8%) and more likely to be insured (79.6% vs 61.3%) (both P <0.001). Between 2010 and 2015, the number and proportion of children and teenagers who had firearm injuries decreased significantly (6769, 21.7% vs. 6118, 17.3%; P for trend <0.001) (Table). Sub-stratification by race/ethnicity and insurance type showed a similar trend across all groups, more marked among Hispanics (1304, 26.4% vs. 848, 19.8%; P for trend <0.001) and those on Medicaid (2581, 39.7% vs. 2940, 28.1%; P for trend <0.001). Analyses of injury categories among patients with firearm injuries showed a decrease in the number and proportion of children and teenagers with assault between 2010 and 2015 (5411, 22.7% vs. 4558, 17.3%; P for trend <0.001) but a similar trend was not seen in self-inflicted injuries (252, 8.7% vs. 311, 9.5%; P for trend= 0.266).
Conclusion: Despite reductions in the numbers and proportions of firearm injuries among children and teenagers, there remains a significant burden of injury among this age group, particularly among Blacks. Variations in socioeconomic factors are associated with trends in firearm injuries. Continued efforts are necessary to ensure safety and reduce firearm injuries among children and teenagers in the United States.
