Freeman Jennifer J, Bachier-Rodriguez Marielena, Staszak Jessica, Feliz Alexander
Division of Pediatric Surgery, University of Tennessee, Health Science Center, Le Bonheur Children's Hospital, 49 North Dunlap, Second Floor, Memphis, TN 38105, USA.
Department of General Surgery, University of Tennessee, Health Science Center, 920 Madison Ave., Memphis, TN 38103, United States.
Injury. 2017 Sep;48(9):1951-1955. doi: 10.1016/j.injury.2017.05.036. Epub 2017 May 29.
Non-powder guns (NPG) are viewed as toys for children by the general public. Literature on firearm injuries in the pediatric population is increasing, however there are still large gaps in the published literature regarding NPG. We intended to identify and compare the epidemiology, circumstances of injury and outcomes of children with NPG versus powder-gun injuries (GSW).
We performed a 6-year retrospective analysis of children 0-14 years old treated for NPG and GSW injuries at our level one pediatric trauma center. Mann-Whitney U test and Pearson's X were used to compare continuous and categorical variables, respectively.
There were 43 NPG and 112 GSWs. Patients were predominantly male (36 children; 84%) NPG vs. 92 children; 82% GSW) with a median age in both groups of 11 years. Analysis of residential zip codes showed that 74% (32 children) NPG injuries and 85% (95 children) GSW lived in regions with higher poverty than the national level. Children with NPG injuries were more likely to be Caucasian (24 children; 56%) and to have suffered an unintentional injury (36 children; 84%), while children with GSW were African-American (80 children; 71%; p=0.0002) and victims of assault (50 children; 45%; p<0.0001). When compared with NPG, children with GSW had more severe injuries, longer hospital stays, and higher overall mortality. There were no significant differences in rate of emergent OR intervention and ED mortality between the two groups.
Our results highlight two important findings. First, NPG injuries were accidental and thus preventable with improved legislation and public education. Second, health disparities related to gun violence among African-Americans are prevalent even in early childhood and prevention efforts should include this younger population.
非火药枪（NPG）在普通大众眼中被视为儿童玩具。关于儿科人群枪支伤害的文献不断增加，然而，已发表的文献中关于非火药枪的内容仍存在很大空白。我们旨在识别并比较非火药枪伤害与火药枪伤害（GSW）儿童的流行病学、受伤情况及预后。
我们对在我们一级儿科创伤中心接受非火药枪和火药枪伤害治疗的0至14岁儿童进行了为期6年的回顾性分析。分别使用曼-惠特尼U检验和皮尔逊X检验来比较连续变量和分类变量。
共有43例非火药枪伤害和112例火药枪伤害。患者以男性为主（非火药枪伤害组36例儿童；84%），火药枪伤害组92例儿童；82%），两组的中位年龄均为11岁。对居住邮政编码的分析表明，74%（32例儿童）的非火药枪伤害和85%（95例儿童）的火药枪伤害患儿居住在贫困程度高于全国水平的地区。非火药枪伤害的儿童更可能是白种人（24例儿童；56%）且遭受意外伤害（36例儿童；84%），而火药枪伤害的儿童是非裔美国人（80例儿童；71%；p = 0.0002）且是袭击受害者（50例儿童；45%；p < 0.0001）。与非火药枪伤害相比，火药枪伤害的儿童伤势更严重、住院时间更长且总体死亡率更高。两组之间急诊手术室干预率和急诊死亡率无显著差异。
我们的结果突出了两个重要发现。第一，非火药枪伤害是意外事故，因此通过改进立法和公众教育是可以预防的。第二，即使在幼儿期，非裔美国人中与枪支暴力相关的健康差异也很普遍，预防措施应包括这一年轻人群。
