S. M. Koenig1,2, R. T. Russell1,2, D. Payne1, M. Chen1,2 1The Children’s Hospital Of Alabama, Birmingham, AL, USA 2University Of Alabama at Birmingham, Birmingham, Alabama, USA
Introduction: Firearm injury is the leading cause of death in children. The recent rise coincided with the COVID-19 pandemic. The purpose of this study was to evaluate trends of pediatric gunshot injuries over a five-and-a-half year period, which included the COVID-19 pandemic, at our level 1 pediatric trauma center.
Methods: A retrospective review of the trauma registry at our free-standing children’s hospital from January 2018 to July 2023 was performed. The variables evaluated included year of injury, age of injury, race, gender, and insurance type.
Results: There were 376 patients identified over the five-and-a-half year period. The mean age of patients was 10.3 +/- 5.4 years. Most were male (70.5%) and of black race (74.5%). A majority of children who sustained a firearm injury had Medicaid (77.1%). During the baseline years of 2018 and 2019 we evaluated 40 pediatric patients each year with firearm injuries. Over the next two years, there was a dramatic increase in pediatric firearm injuries with an increase of 67.5% (N=67) in 2020 and 105% (N=82) in 2021. Although there was less of an increase in 2022, there was still an increase of 87.5% (N=75) above the baseline years. As of July 2023, we have evaluated 72 pediatric patients with firearm injuries and this projects by the years end to be a 209% rise from baseline.
Conclusion: The number of firearm injuries dramatically increased during the COVID-19 pandemic and these increases have been sustained. Most of the injured have been male, of black race, and publicly insured. While the state population of Alabama is 27% black, black children account for 74.5% of all firearm injured children in our trauma registry. Further investigation into specific patient demographics, injury intent, morbidity, mortality, and injury patterns will allow us to better utilize effective targeted education and prevention strategies.