Dempsey Jaclyn, Cain Cary, Kasbaum Marie, Benavides Elisa, Schaeffer August, Torres Glenda, Espino Elena, Naik-Mathuria Bindi
University of Texas Medical Branch, 301 Harborside Drive, Galveston, TX 77555, USA.
Baylor College of Medicine, 6701 Fannin St., Suite 1210, Houston, TX 77030, USA.
J Pediatr Surg. 2025 Jan;60(1):161911. doi: 10.1016/j.jpedsurg.2024.161911. Epub 2024 Sep 7.
Institutional trauma registries, which contribute data to the National Trauma Data Bank, are a fundamental resource for trauma research, though may have significant deficits in data accuracy. We hypothesize that inaccuracies in shooting intent exist at institutional registries of pediatric trauma centers.
Pediatric firearm injuries (ages 0-17 years) in a single county between 2018 and 2020 were identified from three Level I trauma centers. Demographics and Ecodes were extracted from each registry and shooting intent was compared to retrospective review of the hospital records, including bystander as a category.
Of 410 pediatric firearm injuries included, the majority were male (84%), non-Hispanic Black (45%) or Hispanic White (40%), and 15-17 years old (69%). Compared to final reviewer designations, the trauma registry's assault category showed high sensitivity (88.5%), but low specificity (67%), and only 78% accuracy. The trauma registry's accidental category was less sensitive (88%) but more specific (88%), with an accuracy of 88%. The most specific and accurate intention category was intentional self-harm, which had 79% sensitivity, 99.5% specificity, and 99% accuracy. Bystander shootings were most commonly categorized as assault (75%), followed by accidental (18%).
Significant inaccuracies in coding of pediatric firearm shooting intent exist in trauma registries. Additionally, there is no Ecode for bystander shootings, which overestimates other intent categories. Our study highlights the importance of improving the accuracy of firearm injury data collection to provide a better understanding of firearm injuries at a national level to inform targeted prevention efforts specific to shooting types.
III.
向国家创伤数据库提供数据的机构创伤登记处是创伤研究的重要资源，但其数据准确性可能存在重大缺陷。我们假设儿科创伤中心的机构登记处存在枪击意图编码不准确的情况。
从三个一级创伤中心识别出2018年至2020年间一个县内的儿科火器伤（0至17岁）。从每个登记处提取人口统计学和生态编码，并将枪击意图与医院记录的回顾性审查进行比较，包括将旁观者作为一个类别。
在纳入的410例儿科火器伤中，大多数为男性（84%），非西班牙裔黑人（45%）或西班牙裔白人（40%），年龄在15至17岁之间（69%）。与最终审核人员的指定相比，创伤登记处的攻击类别显示出高敏感性（88.5%），但特异性低（67%），准确率仅为78%。创伤登记处的意外类别敏感性较低（88%）但特异性较高（88%），准确率为88%。最具特异性和准确性的意图类别是故意自残，其敏感性为79%，特异性为99.5%，准确率为99%。旁观者枪击最常被归类为攻击（75%），其次是意外（18%）。
创伤登记处存在儿科火器枪击意图编码的重大不准确情况。此外，没有旁观者枪击的生态编码，这高估了其他意图类别。我们的研究强调了提高火器伤数据收集准确性的重要性，以便在国家层面更好地了解火器伤，为针对特定枪击类型的预防工作提供信息。
III级。
