Glassman Taylor, Geller Jennifer E, Burjonrappa Sathyaprasad
Medical Student, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA.
Resident Physician, Thomas Jefferson University Hospital, Department of Surgery, Philadelphia, PA, USA.
J Pediatr Surg. 2025 Mar;60(3):162012. doi: 10.1016/j.jpedsurg.2024.162012. Epub 2024 Oct 18.
Firearm injury is the leading cause of death among pediatric patients in the United States. Unintentional firearm injury remains underexplored compared to intentional firearm injury. This study aims to characterize risk factors and demographics associated with pediatric unintentional firearm injury.
Retrospective analysis of pediatric patients (≤18 years) with firearm injuries from 2017-2022 using the ACS National Trauma Databank. Firearm injuries were identified via ICD-10 codes, classified by intent, and place of injury. Analysis involved univariate, multivariate, and regression models to identify factors associated with unintentional injury.
Of the 42,152 pediatric firearm injuries, 17.6% (n = 8043) were unintentional. Predominantly occurring at home (56.2%), these injuries mostly involved Black (45.7%) or White (42.0%) males (82.3%) aged 12-18 (74.1%). Children aged 2-5 experienced a higher number of unintentional injuries than intentional (1,064 vs. 770). Unintentional injuries were less severe (ISS >16: 10.9% vs. 17.3%, p<0.001) and less fatal (6.7% vs. 12.6%, p<0.001) compared to intentional injuries. Children aged 2-5 had higher odds of unintentional injury (OR 1.98, p<0.001), while adolescents aged 12-18 had lower odds (OR 0.32, p<0.001). Injuries at home were associated with higher odds of being unintentional (OR 1.61, p<0.001), while those on streets or roads were more likely intentional (OR 0.34, p<0.001).
Unintentional firearm injuries, while less severe and fatal, represent a substantial proportion of pediatric firearm trauma in the U.S. These injuries pose significant risks to younger children, often in domestic settings.
III.
在美国，火器伤是儿科患者死亡的主要原因。与故意火器伤相比，非故意火器伤仍未得到充分研究。本研究旨在描述与儿科非故意火器伤相关的风险因素和人口统计学特征。
使用美国外科医师学会国家创伤数据库对2017年至2022年期间有火器伤的儿科患者（≤18岁）进行回顾性分析。通过国际疾病分类第十版代码识别火器伤，按意图和受伤地点进行分类。分析采用单变量、多变量和回归模型，以确定与非故意伤害相关的因素。
在42152例儿科火器伤中，17.6%（n = 8043）为非故意伤。这些损伤主要发生在家中（56.2%），大多涉及12至18岁（74.1%）的黑人（45.7%）或白人（42.0%）男性（82.3%）。2至5岁儿童的非故意伤害数量高于故意伤害（1064例对770例）。与故意伤害相比，非故意伤害的严重程度较低（损伤严重度评分>16：10.9%对17.3%，p<0.001），死亡率也较低（6.7%对12.6%，p<0.001）。2至5岁儿童发生非故意伤害的几率较高（比值比1.98，p<0.001），而12至18岁青少年的几率较低（比值比0.32，p<0.001）。在家中受伤与非故意伤害几率较高相关（比值比1.61，p<0.001），而在街道或道路上受伤更可能是故意的（比值比0.34，p<0.001）。
非故意火器伤虽然严重程度和致死率较低，但在美国儿科火器创伤中占相当大的比例。这些损伤对年幼儿童构成重大风险，且往往发生在家庭环境中。
三级
