Division of Neurosurgery, Texas Children's Hospital, Houston, Texas, USA.
Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA.
Neurosurgery. 2022 Aug 1;91(2):239-246. doi: 10.1227/neu.0000000000002025. Epub 2022 May 12.
Firearm-related injury is a significant cause of morbidity and mortality in pediatric populations. Despite a disproportionate role in the most morbid outcomes in both traumatic brain injury and firearm-related injury populations, firearm-related traumatic brain injury (frTBI) is an understudied epidemiological entity. There is need to increase understanding and promote interventions that reduce this burden of disease.
To assess the evidence characterizing pediatric frTBI to highlight trends and gaps regarding burden of disease and interventions to reduce frTBI.
We conducted a scoping review under Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Scoping Review (PRISMA-ScR) guidelines on peer-reviewed studies across 5 databases (Medline OVID, EMBASE, Web of Science Legal Collection, PsychINFO, and Academic Search Complete). English studies examining pediatric frTBI epidemiology, prevention, and/or social or legal policy advocacy were included. Articles were excluded if they more generally discussed pediatric firearm-related injury without specific analysis of frTBI.
Six studies satisfied inclusion criteria after screening and full-text assessment. Limited studies specifically addressed the burden of disease caused by frTBI. There was an increased risk for both injury and death from frTBI in men, preteenage and teenage youths, minorities, and individuals in firearm-owning households. Further study is required to ascertain if suggested methods of targeted patient screening, firearm-injury prevention counseling, and advocacy of safety-oriented policy tangibly affect rates or outcomes of pediatric frTBI.
By understanding published epidemiological data and areas of intervention shown to reduce frTBIs, neurosurgeons can become further engaged in public health and prevention rather than strictly treatment after injury.
火器相关伤害是儿科人群发病率和死亡率的一个重要原因。尽管在创伤性脑损伤和火器相关伤害人群中，最严重的后果中占比不成比例，但火器相关创伤性脑损伤（frTBI）是一个研究不足的流行病学实体。需要增加对这种疾病负担的理解，并促进减少这种负担的干预措施。
评估描述儿科 frTBI 的证据，以突出有关疾病负担和减少 frTBI 的干预措施的趋势和差距。
我们根据系统评价和荟萃分析的首选报告项目（PRISMA-ScR）指南，在 5 个数据库（Medline OVID、EMBASE、Web of Science 法律收藏、PsychINFO 和 Academic Search Complete）中对同行评审研究进行了范围审查。纳入了研究儿科 frTBI 流行病学、预防和/或社会或法律政策倡导的英语研究。如果文章更广泛地讨论了儿科火器相关伤害，而没有对 frTBI 进行具体分析，则将其排除在外。
经过筛选和全文评估，有 6 项研究符合纳入标准。有限的研究专门讨论了 frTBI 造成的疾病负担。男性、未成年和青少年、少数族裔以及拥有枪支家庭的个体，frTBI 受伤和死亡的风险增加。需要进一步研究以确定针对患者筛查、火器伤害预防咨询和倡导以安全为导向的政策的建议方法是否会切实影响儿科 frTBI 的发生率或结局。
通过了解已发表的流行病学数据和已证明可减少 frTBIs 的干预领域，神经外科医生可以进一步参与公共卫生和预防工作，而不仅仅是在受伤后进行治疗。
