Woodruff Grant, Palmer Lilly, Fontane Emily, Kalynych Colleen, Hendry Phyllis, Thomas Arielle C, Crandall Marie
University of Florida College of Medicine Jacksonville, Department of Surgery, USA.
East Carolina University Department of Surgery, Greenville, NC, USA.
Prev Med Rep. 2022 Jul 5;28:101890. doi: 10.1016/j.pmedr.2022.101890. eCollection 2022 Aug.
Pediatric firearm violence carries significant morbidity and mortality. Studies targeting children ≤14 years are limited. Our goal was to study the distribution and determinants of GSWs in the pediatric population. We performed a retrospective review of children ≤14 years presenting with GSWs at this level 1 trauma center. This cohort was split into younger children, 0-12 years, and older children, 13-14 years. Summary and bivariate statistics were calculated using Stata v10. 142 patients (68.3% black, 76.7% male) were identified. Injuries more often occurred at home (39.6%) by family or friends (60.7%). Older children often suffered handgun injuries (85.5%) and more often were sent immediately to the OR on presentation (29.2%). Younger children more often suffered from air-gun (50%) and pistols (40%). Younger children more commonly had blood transfusions (9.4%) compared to exploratory laparotomy in older children (13.5%). The most common disposition from the ED was home (36.2%). Descriptive data entailing incident specifics such as time of injury and CPS involvement were frequently missing in the healthcare record. Older children were more likely to be injured by strangers, have longer lengths of stay especially associated with surgical operations, and have a disposition of immediate arrest compared to their younger cohort. Consequently, this group may benefit from interventions typically aimed at older patients such as violence intervention programs. When available, differences in demographics and outcomes were identified which could shape novel prevention strategies for firearm injury.
小儿枪支暴力导致严重的发病率和死亡率。针对14岁及以下儿童的研究有限。我们的目标是研究小儿群体中枪伤的分布情况及决定因素。我们对这家一级创伤中心收治的14岁及以下枪伤儿童进行了回顾性研究。该队列分为年幼儿童（0 - 12岁）和年长儿童（13 - 14岁）。使用Stata v10计算了汇总统计量和双变量统计量。共识别出142例患者（68.3%为黑人，76.7%为男性）。受伤情况更多发生在家里（39.6%），由家人或朋友造成伤害的比例为60.7%。年长儿童常受手枪伤害（85.5%），就诊时更常直接被送往手术室（29.2%）。年幼儿童更多受气枪（50%）和手枪（40%）伤害。与年长儿童的剖腹探查术（13.5%）相比，年幼儿童更常接受输血（9.4%）。急诊室最常见的处置方式是回家（36.2%）。医疗记录中经常缺少诸如受伤时间和儿童保护服务介入等事件细节的描述性数据。与年幼儿童队列相比，年长儿童更可能被陌生人伤害，住院时间更长，尤其是与外科手术相关的住院时间，并且处置方式为立即逮捕。因此，这一群体可能受益于通常针对年长患者的干预措施，如暴力干预项目。若可行，可确定人口统计学和结局方面的差异，这有助于制定新的枪支伤害预防策略。
