Cardiovascular Outcomes Research Laboratories (CORELAB), Division of Cardiac Surgery, David Geffen School of Medicine, University of California, Los Angeles, CA; Division of Pediatric Critical Care, David Geffen School of Medicine, University of California, Los Angeles, CA.
Cardiovascular Outcomes Research Laboratories (CORELAB), Division of Cardiac Surgery, David Geffen School of Medicine, University of California, Los Angeles, CA.
J Pediatr. 2021 Sep;236:172-178.e4. doi: 10.1016/j.jpeds.2021.05.018. Epub 2021 May 13.
To characterize hospitalization costs attributable to gun-related injuries in children across the US.
The 2005-2017 National Inpatient Sample was used to identify all pediatric admissions for gunshot wounds (GSW). Patients were stratified by International Classification of Diseases procedural codes for trauma-related operations. Annual trends in GSW hospitalizations and costs were analyzed with survey-weighted estimates. Multivariable regressions were used to identify factors associated with high-cost hospitalizations.
During the study period, an estimated 36 283 pediatric patients were admitted for a GSW, with 43.1% undergoing an operative intervention during hospitalization. Admissions for pediatric firearm injuries decreased from 3246 in 2005 to 3185 in 2017 (NPtrend < .001). The median inflation-adjusted cost was $12 408 (IQR $6253-$24 585). Median costs rose significantly from $10 749 in 2005 to $16 157 in 2017 (P < .001). Compared with those who did not undergo surgical interventions, operative patients incurred increased median costs ($18 576 vs $8942, P < .001). Assault and self-harm injuries as well as several operations were independently associated with classification in the highest cost tertile.
Admissions for pediatric firearm injuries were associated with a significant socioeconomic burden in the US, with increasing resource use over time. Pediatric gun violence is a major public health crisis that warrants further research and advocacy to reduce its prevalence and social impact.
描述美国儿童与枪支相关伤害住院费用的特征。
利用 2005-2017 年国家住院患者样本，确定所有因枪击伤（GSW）住院的儿科患者。根据与创伤相关手术的国际疾病分类程序代码，将患者分层。使用调查加权估计分析 GSW 住院和费用的年度趋势。多变量回归用于确定与高成本住院相关的因素。
在研究期间，估计有 36283 名儿科患者因 GSW 住院，其中 43.1%在住院期间接受了手术干预。儿科火器伤害的入院人数从 2005 年的 3246 人减少到 2017 年的 3185 人（NPtrend<.001）。经通胀调整后的中位数费用为 12408 美元（IQR 6253-24585）。中位数费用从 2005 年的 10749 美元显著上升至 2017 年的 16157 美元（P<.001）。与未接受手术干预的患者相比，接受手术的患者的中位费用增加（18576 美元与 8942 美元，P<.001）。袭击和自残伤害以及几种手术与分类为最高费用三分位数独立相关。
在美国，儿科火器伤害住院与重大的社会经济负担相关，随着时间的推移，资源使用不断增加。儿科枪支暴力是一个重大的公共卫生危机，需要进一步研究和宣传，以减少其流行程度和社会影响。
