Brown School of Social Work, Washington University in St. Louis, St. Louis, Missouri (Z.M.M.).
Institute for Public Health, Washington University in St. Louis School of Medicine, St. Louis, Missouri (B.P.C.).
Ann Intern Med. 2024 Oct;177(10):1381-1388. doi: 10.7326/M24-0430. Epub 2024 Sep 17.
Firearm injuries are the leading cause of death among children aged 0 to 17 years in the United States.
To examine the factors associated with recurrent firearm injury among children who presented with acute (index) nonfatal firearm injury in the St. Louis region.
Multicenter, observational, cohort study.
2 adult and 2 pediatric level I trauma hospitals in St. Louis, Missouri.
Pediatric patients aged 0 to 17 years presenting with an index firearm injury between 2010 and 2019.
From the St. Louis Region-Wide Hospital-Based Violence Intervention Program Data Repository, we collected data on firearm-injured patient demographics, hospital and diagnostic information, health insurance status, and mortality. The Social Vulnerability Index was used to characterize the social vulnerability of the census tracts of patients' residences. Analysis included descriptive statistics and time-to-event analyses estimating the cumulative incidence of experiencing a recurrent firearm injury.
During the 10-year study period, 1340 children presented with an index firearm injury. Most patients were Black (87%), non-Hispanic (99%), male (84%), and between the ages of 15 and 17 years (67%). The estimated risk for firearm reinjury was 6% at 1 year and 14% at 5 years after initial injury. Male children and those seen at an adult hospital were at increased risk for reinjury.
Our data set does not account for injuries occurring outside of the study period and for reinjuries presenting to nonstudy hospitals.
Children who experience an initial firearm injury are at high risk for experiencing a recurrent firearm injury. Interventions are needed to reduce reinjury and address inequities in the demographic and clinical profiles within this cohort of children.
National Institutes of Health.
在美国，0 至 17 岁儿童因枪支受伤是导致死亡的首要原因。
研究圣路易斯地区因急性（索引）非致命性枪支受伤就诊的儿童中，与再次发生枪支伤害相关的因素。
多中心、观察性、队列研究。
密苏里州圣路易斯的 2 家成人和 2 家儿科一级创伤医院。
2010 年至 2019 年期间因索引枪支伤害就诊的 0 至 17 岁儿科患者。
我们从圣路易斯地区全范围医院暴力干预计划数据存储库中收集了枪支伤害患者人口统计学、医院和诊断信息、医疗保险状况和死亡率数据。社会脆弱性指数用于描述患者居住地的普查区的社会脆弱性。分析包括描述性统计和时间事件分析，估计再次发生枪支伤害的累积发生率。
在 10 年的研究期间，有 1340 名儿童因索引枪支伤害就诊。大多数患者为黑人（87%）、非西班牙裔（99%）、男性（84%），年龄在 15 至 17 岁之间（67%）。最初受伤后 1 年和 5 年再次发生枪支伤害的风险估计分别为 6%和 14%。男性儿童和在成人医院就诊的儿童再次受伤的风险增加。
我们的数据集不包括研究期间之外发生的伤害和非研究医院就诊的再伤害。
经历初次枪支伤害的儿童再次发生枪支伤害的风险很高。需要采取干预措施，以减少再次受伤，并解决这一儿童队列中在人口统计学和临床特征方面的不平等问题。
美国国立卫生研究院。
