Bernardin Mary Elizabeth, Moen Joseph, Schnadower David
Division of Emergency Medicine, Department of Pediatrics, Washington University School of Medicine, St. Louis, MO; Division of Pediatric Emergency Medicine, Department of Emergency Medicine, University of Missouri School of Medicine, Columbia, MO.
Division of Biostatistics, Washington University School of Medicine, St. Louis, MO.
J Pediatr Surg. 2021 Apr;56(4):754-759. doi: 10.1016/j.jpedsurg.2020.06.025. Epub 2020 Jun 24.
To identify factors associated with firearm injury (FI) and willingness to enroll in a violence intervention program amongst pediatric victims of violence.
Cross-sectional study of victims of violence age 6-19 years presenting to a children's hospital emergency department from 2014 to 2017. Participants were interviewed by social workers prior to being offered enrollment in a violence intervention program. We used multivariate logistic regression analyses to identify factors associated with FI and enrollment in the violence intervention program.
Four hundred seven patients were analyzed, 156 (38%) of which were victims of FI and 251 (62%) were victims of non-firearm-related physical assaults (PA). Multiple factors were associated with FI including older adolescent age, male sex, separated/divorced parents, losses in family/social network due to violence, being on probation, illicit substance use, gang affiliation, and lack of school enrollment. One hundred four patients (26%) enrolled in the violence intervention program. There was no difference in enrollment between FI and PA. However, older adolescent age, illicit substance use and probation were associated with significantly decreased odds of enrolling in the program.
Multiple identifiable and potentially actionable risk factors exist amongst pediatric victims of acute FI. More specific targeting of at-risk groups may improve enrollment in violence interventions programs.
This is a prognostic study, investigating the natural history of pediatric firearm injuries, factors associated with firearm injuries as well as those associated with patient propensity to enroll in a violence intervention program. This study is observational in nature and utilizes patients with non-firearm-related physical assaults as a control group, making this study Level III evidence.
确定与枪支伤害（FI）相关的因素，以及暴力事件儿科受害者参与暴力干预项目的意愿。
对2014年至2017年到儿童医院急诊科就诊的6至19岁暴力事件受害者进行横断面研究。在参与者被邀请加入暴力干预项目之前，由社会工作者对其进行访谈。我们使用多变量逻辑回归分析来确定与FI以及参与暴力干预项目相关的因素。
对407名患者进行了分析，其中156名（38%）是FI受害者，251名（62%）是非枪支相关身体攻击（PA）的受害者。与FI相关的多个因素包括青少年年龄较大、男性、父母分居/离婚、因暴力导致家庭/社交网络中的损失、处于缓刑期、非法药物使用、帮派关系以及未入学。104名患者（26%）参与了暴力干预项目。FI和PA患者在参与率上没有差异。然而，青少年年龄较大、非法药物使用和缓刑与参与该项目的几率显著降低相关。
在急性FI的儿科受害者中存在多种可识别且可能可采取行动的风险因素。对高危群体进行更有针对性的干预可能会提高暴力干预项目的参与率。
这是一项预后研究，调查儿科枪支伤害的自然史、与枪支伤害相关的因素以及与患者参与暴力干预项目倾向相关的因素。本研究本质上是观察性的，并将非枪支相关身体攻击的患者作为对照组，因此本研究为III级证据。
