Department of Emergency Medicine, Center for Policy and Research in Emergency Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, mailcode CR-114, Portland, OR 97239-3098.
Pediatrics. 2013 Nov;132(5):862-70. doi: 10.1542/peds.2013-1350. Epub 2013 Oct 14.
To describe the incidence, injury severity, resource use, mortality, and costs for children with gunshot injuries, compared with other injury mechanisms.
This was a population-based, retrospective cohort study (January 1, 2006-December 31, 2008) including all injured children age ≤ 19 years with a 9-1-1 response from 47 emergency medical services agencies transporting to 93 hospitals in 5 regions of the western United States. Outcomes included population-adjusted incidence, injury severity score ≥ 16, major surgery, blood transfusion, mortality, and average per-patient acute care costs.
A total of 49,983 injured children had a 9-1-1 emergency medical services response, including 505 (1.0%) with gunshot injuries (83.2% age 15-19 years, 84.5% male). The population-adjusted annual incidence of gunshot injuries was 7.5 cases/100,000 children, which varied 16-fold between regions. Compared with children who had other mechanisms of injury, those injured by gunshot had the highest proportion of serious injuries (23%, 95% confidence interval [CI] 17.6-28.4), major surgery (32%, 95% CI 26.1-38.5), in-hospital mortality (8.0%, 95% CI 4.7-11.4), and costs ($28,510 per patient, 95% CI 22,193-34,827).
Despite being less common than other injury mechanisms, gunshot injuries cause a disproportionate burden of adverse outcomes in children, particularly among older adolescent males. Public health, injury prevention, and health policy solutions are needed to reduce gunshot injuries in children.
描述枪击伤患儿的发生率、损伤严重程度、资源利用、死亡率和费用，与其他损伤机制进行比较。
这是一项基于人群的回顾性队列研究（2006 年 1 月 1 日至 2008 年 12 月 31 日），纳入了美国西部 5 个地区的 47 家急救医疗服务机构转运至 93 家医院的所有年龄≤19 岁、因 9-1-1 急救响应受伤的儿童。结局包括人群调整后的发生率、损伤严重程度评分≥16、主要手术、输血、死亡率和每位患者急性护理的平均费用。
共有 49983 名受伤儿童有 9-1-1 急救医疗服务响应，其中 505 名（1.0%）有枪击伤（83.2%年龄为 15-19 岁，84.5%为男性）。枪击伤的人群调整年发生率为 7.5 例/10 万儿童，地区间差异高达 16 倍。与因其他损伤机制受伤的患儿相比，枪击伤患儿严重损伤的比例（23%，95%置信区间[CI]17.6%-28.4%）、主要手术（32%，95%CI26.1%-38.5%）、院内死亡率（8.0%，95%CI4.7%-11.4%）和费用（每位患者 28510 美元，95%CI22193-34827 美元）均最高。
尽管枪击伤比其他损伤机制少见，但在儿童中造成的不良结局负担不成比例，尤其是在年龄较大的青少年男性中。需要采取公共卫生、伤害预防和卫生政策措施来减少儿童枪击伤。
