Tatebe Leah C, Sanchez Joseph, Pekarek Sydney, Koo Nathaniel, Mis Justin, Schlanser Victoria, Bokhari Faran, Dennis Andrew J
Department of Trauma and Burn Surgery, Cook County Health, Rush University, Midwestern University, Chicago, Illinois.
Department of Trauma and Burn Surgery, Cook County Health, Northwestern University, Chicago, Illinois.
J Surg Res. 2021 Nov;267:719-725. doi: 10.1016/j.jss.2021.04.046. Epub 2021 Jul 17.
Firearm-related injury is a public health crisis and remains the 3rd most common cause of death from ages 1 15 years. By evaluating events surrounding such injuries, evidence-based intervention strategies efforts may be targeted to maximize impact.
A retrospective chart review was performed for firearm-related injuries in patients 15 years-old and under at an urban Pediatric Level 1 Trauma Center between January 2016 and December 2020. Age, gender, race/ethnicity, injury severity score (ISS), reported cause of injury, timing of injury around school and curfew, and mortality were evaluated. Medical Examiner data identified other deaths that occurred within the hospital's catchment area.
There were 195 injuries including 14 from the Medical Examiner. Overall, 82.6% were male with median age of 14 years (range 1-15; IQR 13-15), and median ISS of 5 (IQR 1-10). African-American children comprised 74.9% of the cohort while only representing 35.9% of local schools. Intentional interpersonal injuries comprised 65.6%; 17.4% were bystanders; 7.2% were negligent discharges; and 0.5% suicide. Median age for intentional interpersonal injuries was 14 years (IQR 13-15) compared to 11 years (IQR 8-14, P = 0.03) for negligent discharges. Regarding timing, 6.9% of injuries occurred during school hours; 56.4% after school or during non-school days; and 36.7% were after legal curfew. Mortality rate was 17.4%.
Firearm safety education and community-based violence intervention should start in the pre-teen years. Pediatric firearm-related injury prevention strategies must be multifaceted addressing structural racism, truancy, curfew violation, extra-curricular activities, childcare options, firearm safety education, violence reduction, suicide prevention, and recidivism.
枪支相关伤害是一场公共卫生危机，仍是1至15岁人群中第三大常见死因。通过评估此类伤害周围的事件，基于证据的干预策略和努力可以有针对性地最大化影响。
对2016年1月至2020年12月期间，一家城市一级儿科创伤中心15岁及以下因枪支相关伤害的患者进行回顾性病历审查。评估了年龄、性别、种族/族裔、损伤严重程度评分（ISS）、报告的伤害原因、学校周围和宵禁时间的伤害时间以及死亡率。法医数据确定了在医院服务区域内发生的其他死亡情况。
共有195例伤害，其中14例来自法医。总体而言，82.6%为男性，中位年龄为14岁（范围1至15岁；四分位间距13至15岁），中位ISS为5（四分位间距1至10）。非裔美国儿童占该队列的74.9%，而仅占当地学校学生的35.9%。人际故意伤害占65.6%；17.4%为旁观者；7.2%为疏忽开枪；0.5%为自杀。人际故意伤害的中位年龄为14岁（四分位间距13至15岁），而疏忽开枪的中位年龄为11岁（四分位间距8至14岁，P = 0.03）。关于时间，6.9%的伤害发生在上学时间；56.4%发生在放学后或非上课日；36.7%发生在法定宵禁之后。死亡率为十七点四%。
枪支安全教育和基于社区的暴力干预应在青少年前期开始。预防儿童枪支相关伤害的策略必须是多方面的，要解决结构性种族主义、逃学、违反宵禁、课外活动、儿童保育选择、枪支安全教育、减少暴力、预防自杀和累犯问题。
