Joudi Noor, Tashiro Jun, Golpanian Samuel, Eidelson Sarah A, Perez Eduardo A, Sola Juan E
Division of Pediatric Surgery, DeWitt-Daughtry Department of Surgery, Miller School of Medicine, University of Miami, Miami, Florida.
Division of Pediatric Surgery, DeWitt-Daughtry Department of Surgery, Miller School of Medicine, University of Miami, Miami, Florida.
J Surg Res. 2017 Jun 15;214:140-144. doi: 10.1016/j.jss.2017.03.007. Epub 2017 Mar 16.
Firearm injuries related to legal intervention have come under scrutiny because of recent events.
The Kids' Inpatient Database (1997-2012) was searched for firearm injuries due to legal interventions (International Classification of Diseases, ninth revision, Clinical Modification E970) requiring inpatient admission in children aged <20 y. Cases were weighted to provide national estimates. The Brady Campaign criteria were used to identify lenient versus strict gun law states.
Overall, 275 cases were identified, with a 7.5% mortality rate. Incidence peaked at 1.0 per 100,000 admissions in 2006, significantly increased from a low 0.2 per 100,000 admissions in 1997, P < 0.001. Patients were predominantly male (97%). African Americans (44%) represented the largest racial group, followed by Hispanics (30%) and Caucasians (20%). Mean age was 17.5 ± 2.08 y. Patients were insured by Medicaid (33%) or a private payer (24%); the remainder (43%) was uninsured. Admissions most frequently occurred at urban teaching hospitals (81%). Cases occurred most frequently in the Southern United States (44%), followed by the Western United States (35%). Most patients presented to non-children's hospitals (97%). Mean hospital admission cost was 27,507 ± 40,197 USD, whereas mean charges amounted to 75,905 ± 116,622 USD. Cases mostly occurred in lenient (56%) gun law states, whereas the remainder occurred in strict (41%) and neutral (3%) states. When analyzed by race, Caucasians (16%) had a significantly higher mortality rate when compared with African Americans (5%), P = 0.03.
An analysis of this very specific injury mechanism demonstrates important findings, which are difficult to collect from conventional data sources. Future research will contribute to the objective analysis of this politically charged subject.
由于近期事件，与法律干预相关的枪支伤害受到了审查。
在儿童住院数据库（1997 - 2012年）中搜索因法律干预导致的枪支伤害（国际疾病分类第九版，临床修订本E970），这些伤害需要对20岁以下儿童进行住院治疗。对病例进行加权以提供全国估计数。使用布雷迪运动标准来确定枪支法律宽松与严格的州。
总体而言，共识别出275例病例，死亡率为7.5%。发病率在2006年达到每10万例入院病例1.0例的峰值，从1997年每10万例入院病例0.2例的低水平显著增加，P < 0.001。患者主要为男性（97%）。非裔美国人（44%）是最大的种族群体，其次是西班牙裔（30%）和白种人（20%）。平均年龄为17.5 ± 2.08岁。患者由医疗补助计划（33%）或私人付款人（24%）承保；其余（43%）未参保。入院最常发生在城市教学医院（81%）。病例最常发生在美国南部（44%），其次是美国西部（35%）。大多数患者前往非儿童医院就诊（97%）。平均住院费用为27,507 ± 40,197美元，而平均收费为75,905 ± 116,622美元。病例大多发生在枪支法律宽松的州（56%），其余发生在严格（41%）和中立（3%）的州。按种族分析时，白种人（16%）的死亡率显著高于非裔美国人（5%），P = 0.03。
对这种非常特殊的伤害机制进行分析显示了重要发现，这些发现难以从传统数据源收集。未来的研究将有助于对这个充满政治争议的主题进行客观分析。
