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儿科枪支伤害:医疗保健结果的种族差异和预测因素。

Pediatric firearm injuries: Racial disparities and predictors of healthcare outcomes.

机构信息

Department of Surgery, University of Texas Medical Branch, 301 University Blvd., Galveston, TX, 77555, USA.

Division of Pediatric Surgery, University of Texas Medical Branch, 301 University Blvd., Galveston, TX, 77555, USA.

出版信息

J Pediatr Surg. 2020 Aug;55(8):1596-1603. doi: 10.1016/j.jpedsurg.2020.02.021. Epub 2020 Feb 20.

Abstract

BACKGROUND/PURPOSE: The U.S. has an alarming rate of firearm injuries. Racial disparities among victims and predictors of outcomes are not well established. Our objective was to assess costs, length of stay (LOS), and inpatient mortality among nonfatal and fatal pediatric firearm injuries that required hospitalization.

METHODS

Pediatric (≤18 years of age) hospitalizations with a firearm injury discharge diagnosis were identified from the national Kids' Inpatient Databases (KID) for 2006 through 2012. Firearm injury intent, weapon type, and hospitalization rates by racial groups were examined. Inpatient mortality, costs, and length of stay were examined using regression models.

RESULTS

Of 15,211 hospitalizations, the majority of injuries were due to assault (60%) and the intentions of firearm injury differed by race (p < 0.001). The median cost per hospitalization was $10,159 (interquartile range: $5071 to $20,565), totaling more than a quarter of a billion dollars. On regression analysis, Black (OR: 0.41; CI: 0.30-0.55) and Hispanic (OR: 0.47; CI: 0.34-0.66) patients were less likely to die than White patients.

CONCLUSION

Pediatric firearm injury circumstances and survival vary by race with Whites being more likely to experience unintentional injury and suicide, while Blacks and Hispanics are more likely to experience inflicted injury.

LEVEL OF EVIDENCE

Level II.

TYPE OF STUDY

Clinical Research Study.

摘要

背景/目的:美国的枪支伤害率令人震惊。受害者之间的种族差异以及对结果的预测因素尚未得到充分确立。我们的目的是评估需要住院治疗的非致命性和致命性儿科枪支伤害的成本、住院时间(LOS)和住院内死亡率。

方法

从全国儿童住院数据库(KID)中确定了 2006 年至 2012 年期间患有枪支伤害出院诊断的儿科(≤18 岁)住院患者。检查了枪支伤害意图、武器类型以及按种族划分的住院率。使用回归模型检查了住院内死亡率、成本和住院时间。

结果

在 15211 例住院患者中,大多数伤害是由袭击造成的(60%),枪支伤害的意图因种族而异(p<0.001)。每次住院的中位数费用为 10159 美元(四分位距:5071 美元至 20565 美元),总计超过 25 亿美元。回归分析显示,黑人(OR:0.41;95%CI:0.30-0.55)和西班牙裔(OR:0.47;95%CI:0.34-0.66)患者的死亡率低于白人患者。

结论

儿科枪支伤害的情况和存活率因种族而异,白人更有可能遭受非故意伤害和自杀,而黑人及西班牙裔更有可能遭受故意伤害。

证据水平

二级。

研究类型

临床研究。

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