University of California, Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, Orange, CA, USA.
University of Southern California, Department of Anesthesiology, Los Angeles, CA, USA.
Am J Surg. 2021 Sep;222(3):654-658. doi: 10.1016/j.amjsurg.2020.12.049. Epub 2021 Jan 6.
To perform a national analysis of pediatric firearm violence (PFV), hypothesizing that black and uninsured patients would have higher risk of mortality.
The Trauma Quality Improvement Program (2014-2016) was queried for PFV patients ≤16 years-old. Multivariable logistic regression models on all patients and a subset excluding severe brain injuries were performed.
The PFV mortality rate was 11.2%. 66.5% of PFV patients were black (p < 0.001). Deceased patients were more likely to be uninsured (14.5% vs. 5.3%, p < 0.001). Black race was an associated risk factor for mortality in patients without severe brain injury (OR 5.26, CI 1.00-27.47, p = 0.049) but not for the overall population (OR 1.32, CI 0.68-2.56, p = 0.39).
Nearly two-thirds of PFV patients were black. Contrary to previous studies, black and uninsured pediatric patients did not have an increased risk of mortality overall. However, in a subset of patients without severe brain injury, black race was associated with increased mortality risk.
Between 2014 and 2016 the mortality rate for pediatric firearm violence (PFV) in children 16 years and younger was 11.2%. Although two-thirds of PFV patients were black, black race and lack of insurance were not risk factors of mortality for the overall population. Once patients with severe brain injury were excluded, black race and became associated with an increased risk of mortality.
对儿科枪支暴力（PFV）进行全国性分析，假设黑人和没有保险的患者的死亡率会更高。
查询创伤质量改进计划（2014-2016 年）中≤16 岁的 PFV 患者。对所有患者和排除严重脑损伤的亚组进行多变量逻辑回归模型分析。
PFV 的死亡率为 11.2%。66.5%的 PFV 患者为黑人（p<0.001）。死亡患者更有可能没有保险（14.5%比 5.3%，p<0.001）。在没有严重脑损伤的患者中，黑人种族是死亡的相关危险因素（OR 5.26，CI 1.00-27.47，p=0.049），但在总体人群中并非如此（OR 1.32，CI 0.68-2.56，p=0.39）。
近三分之二的 PFV 患者为黑人。与先前的研究相反，总体而言，黑人和没有保险的儿科患者的死亡率并没有增加。然而，在没有严重脑损伤的患者亚组中，黑种人种族与增加的死亡率风险相关。
在 2014 年至 2016 年期间，16 岁及以下儿童的儿科枪支暴力（PFV）死亡率为 11.2%。尽管 PFV 患者中有三分之二是黑人，但黑人和缺乏保险并不是总体人群死亡的风险因素。一旦排除了严重脑损伤的患者，黑人和种族就与死亡率增加相关。
