Division of Pediatric Surgery, Department of Surgery, Children's of Alabama, University of Alabama at Birmingham, Birmingham, Alabama.
Division of Pediatric Surgery, Department of Surgery, Children's of Alabama, University of Alabama at Birmingham, Birmingham, Alabama.
J Surg Res. 2024 Nov;303:57-62. doi: 10.1016/j.jss.2024.08.020. Epub 2024 Sep 18.
Firearm injury is the leading cause of death in children. The recent rise has coincided with the COVID-19 pandemic. The purpose of this study was to evaluate the trends of pediatric firearm injury over a 6-y period, to include the COVID-19 pandemic, at our pediatric trauma center.
A retrospective review of the trauma registry at a free-standing children's hospital from January 2018 to December 2023 was performed. The variables evaluated included year of injury, age of injury, race, gender, admission requirements, need for blood products, need for operation, mortality, insurance type, and reason for injury.
There were 397 firearm injury presentations identified over the 6-y period. The median age of injury was 13 y with an interquartile range of 6-15 y. Most were male (72.3%) and of Black race (74.6%). A majority of children who sustained a firearm injury had Medicaid (77.8%). During the years of 2018 and 2019, we evaluated 40 and 39 patients, respectively. Over the next 2 y, there was a dramatic increase in pediatric firearm injuries with an increase of 65% (N = 66) in 2020 and 102.5% (N = 81) in 2021. Although there was less of an increase above baseline in 2022, there was still an elevation of 82.5% (N = 73). By the end of 2023, there had been a 145% rise (N = 98) in pediatric firearm injuries above the baseline year of 2018. The mortality rate was 7.6% (N = 30), which is 2.5 times higher than the all-cause trauma mortality of 3.1% at our facility.
The number of firearm injuries dramatically increased during the COVID-19 pandemic and these increases have been sustained. Most of the victims have been male, of Black race, and publicly insured. While the state population of Alabama is 26.4% Black race, Black children account for 74.6% of all firearm-injured pediatric patients in our trauma registry. The reason for this disparity is not well-understood. Through ongoing research, we hope to gain insight into the reasons behind pediatric firearm injury and the best ways to mitigate them through both the medical and public health arenas.
枪支伤害是儿童死亡的主要原因。最近的上升与 COVID-19 大流行同时发生。本研究的目的是评估我们儿童创伤中心在过去 6 年中儿童枪支伤害的趋势，包括 COVID-19 大流行期间的情况。
对一家独立儿童医院的创伤登记处进行回顾性研究，时间为 2018 年 1 月至 2023 年 12 月。评估的变量包括受伤年份、受伤年龄、种族、性别、入院要求、是否需要输血、是否需要手术、死亡率、保险类型和受伤原因。
在 6 年期间，共发现 397 例枪支伤害病例。受伤的中位年龄为 13 岁，四分位间距为 6-15 岁。大多数是男性（72.3%）和黑人（74.6%）。大多数遭受枪支伤害的儿童都有医疗补助（77.8%）。在 2018 年和 2019 年期间，我们分别评估了 40 名和 39 名患者。在接下来的 2 年中，儿童枪支伤害急剧增加，2020 年增加了 65%（N=66），2021 年增加了 102.5%（N=81）。尽管 2022 年的增长低于基线，但仍上升了 82.5%（N=73）。到 2023 年底，与 2018 年基线年相比，儿童枪支伤害增加了 145%（N=98）。死亡率为 7.6%（N=30），是我们医院所有原因创伤死亡率 3.1%的 2.5 倍。
在 COVID-19 大流行期间，枪支伤害的数量急剧增加，而且这种增加一直持续。大多数受害者是男性，是黑人，并且有公共保险。虽然阿拉巴马州的人口中有 26.4%是黑人，但在我们的创伤登记处，黑人儿童占所有枪支伤害的儿科患者的 74.6%。造成这种差异的原因尚不清楚。通过正在进行的研究，我们希望通过医疗和公共卫生领域，深入了解儿童枪支伤害的原因以及通过这些领域减轻伤害的最佳方法。
