Department of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, California.
Department of Pedicatrics, Keck School of Medicine of University of Southern California, Los Angeles, California.
Pediatrics. 2023 Sep 1;152(3). doi: 10.1542/peds.2023-062530.
We aimed to describe changes in pediatric firearm injury rates, severity, and outcomes after the coronavirus disease 2019 stay-at-home order in Los Angeles (LA) County.
A multicenter, retrospective, cross-sectional study was conducted on firearm injuries involving children aged <18-years in LA County before and after the pandemic. Trauma activation data of 15 trauma centers in LA County from the Trauma and Emergency Medicine Information System Registry were abstracted from January 1, 2018, to December 31, 2021. The beginning of the pandemic was set as March 19, 2020, the date the county stay-at-home order was issued, separating the prepandemic and during-pandemic periods. Rates of firearm injuries, severity, discharge capacity, and Child Opportunity Index (COI) were compared between the groups. Analysis was performed with χ2 tests and segmented regression.
Of the 7693 trauma activations, 530 (6.9%) were from firearm injuries, including 260 (49.1%) in the prepandemic group and 270 (50.9%) in the during-pandemic group. No increase was observed in overall rate of firearm injuries after the stay-at-home order was issued (P = .13). However, firearm injury rates increased in very low COI neighborhoods (P = .01). Mechanism of injury, mortality rates, discharge capacity, and injury severity score did not differ between prepandemic and during-pandemic periods (all P values ≥.05).
Although there was no overall increase in pediatric firearm injuries during the pandemic, there was a disproportionate increase in areas of very low neighborhood COI. Further examination of community disparity should be a focus for education, intervention, and development.
我们旨在描述洛杉矶（LA）县在实施 2019 年冠状病毒病居家令后，儿科火器伤害发生率、严重程度和结局的变化。
这是一项多中心、回顾性、横断面研究，对 LA 县 18 岁以下儿童火器伤害病例进行了研究。从 LA 县 15 个创伤中心的创伤和急诊医学信息系统登记处提取了 2018 年 1 月 1 日至 2021 年 12 月 31 日的创伤激活数据。将大流行开始时间设定为 2020 年 3 月 19 日，即该县发布居家令的日期，将大流行前和大流行期间分开。比较两组之间火器伤害的发生率、严重程度、出院能力和儿童机会指数（COI）。采用 χ2 检验和分段回归进行分析。
在 7693 次创伤激活中，有 530 次（6.9%）是火器伤害，其中 260 次（49.1%）发生在大流行前组，270 次（50.9%）发生在大流行期间组。居家令发布后，火器伤害总发生率未见增加（P =.13）。然而，非常低 COI 社区的火器伤害发生率增加（P =.01）。大流行前和大流行期间，损伤机制、死亡率、出院能力和损伤严重程度评分无差异（所有 P 值均≥.05）。
尽管大流行期间儿科火器伤害总体上没有增加，但非常低社区 COI 地区的伤害却不成比例地增加。应进一步关注社区差异，以便为教育、干预和发展提供重点。
