A. Gerk1, T. Wurderman1,2, N. Kumar1,3, S. Hargarten4, T. Dey5, A. Cervantes-Trejo6, J. Lindsay-Poland7, S. Storr7, F. Vega-Rivera8, J. Shalkow11, S. Juran1, T. Uribe-Leitz1,9,10 1Harvard Medical School, Program In Global Surgery And Social Change, Boston, MA, USA 2Loma Linda University Medical Center, Department Of Surgery, Loma Linda, CA, USA 3University of California San Francisco, East Bay, Department Of Surgery, Oakland, CA, USA 4Medical College Of Wisconsin, Department Of Emergency Medicine, Injury Center, Milwaukee, WI, USA 5Brigham and Women’s Hospital, Center For Surgery And Public Health, Department Of Surgery, Boston, MA, USA 6Anahuac University Mexico, Faculty Of Health Sciences, Mexico, MEXICO CITY, USA 7Stop US Arms to Mexico, Mexico, MEXICO CITY, USA 8Hospital Angeles Lomas. UNAM, Department Of Surgery, Mexico, MEXICO CITY, USA 9Boston Children’s Hospital, Department Of Plastic Surgery, Boston, MA, USA 10Technical University of Munich, Germany and Munich Data Science Institute (MDSI), Technical University of Munich, Epidemiology, Department Of Sport And Health Sciences, Munich, BAVARIA, Germany 11National Institute of Pediatrics and ABC Cancer Center, Department Of Surgery, Mexico, MEXICO CITY, Mexico
Introduction: Mexico is among the countries with the highest rates of gunshot wounds (GSW) and has a long-standing history of violence and a significant presence of illicit firearm trafficking. Children and adolescents are particularly vulnerable to the consequences of gun-related incidents. We sought to examine pediatric firearm injury and state firearm prevalence in Mexico.
Methods: Mexican government databases were used to extract public hospital-level data by state for the years 2017-2022 at Ministry of Health (MOH- Secretaria de Salud) facilities. Patients aged 1 to 17 years with GSW were included. The number of illicit firearms seized by the military per state was extracted from the Mexican Secretariat of National Defense (SEDENA) Database. The primary outcome assessed was the GSW rate. A subanalysis assessed the relationship between GSWs, the number of confiscated firearms per state, clinical impacts, and injuries.
Results: From 2017 to 2022, there were 3,883 GSWs in children and young people. GSWs were more prevalent among males(78.7%), particularly those aged 15 -17 (58.7%). Injuries were most commonly located in the extremities, head, and thorax (38.1%, 9.5%, and 9.5%, respectively). 46 (1.6%) of GSW resulted in deaths according to lesiones Dataset and 162 deaths registered in the Defunciones Dataset, in the same period. Guanajuato (1098, 28.2%), State of Mexico (258, 6.6%), Mexico City (255, 6.6%), San·Luis·Potosí (252, 6.4%), and Michoacán· (222, 5.7%) had the highest prevalence of GSWs. The states with higher repossessed firearms were Tamaulipas, Michoacán, Sonora, and Guanajuato.
Conclusion: This Study explores the risk implications of firearm violence on the pediatric population within Mexico's Public Healthcare System. There is high regional variation in pediatric GSWs and firearm prevalence within the MOH. The discordance between mortality rates in MOH and other data sources could be explained by high pre-hospital mortality. This highlights the need for improved data collection across the trauma care continuum, including the implementation of a nationwide trauma registry. This work underscores the need for additional research and targeted data collection to understand the real effect of pediatric firearm injury in Mexico.