Scrushy Marinda G, Abbe Marisa, Wang Shengqing, Stone Genna, Pandya Samir, Ryan Mark
Department of Surgery, UT Southwestern Medical Center, Dallas, Texas.
Department of Surgery, UT Southwestern Medical Center, Dallas, Texas; Children's Medical Center Dallas, Dallas, Texas.
J Surg Res. 2024 Dec;304:365-370. doi: 10.1016/j.jss.2024.10.027. Epub 2024 Nov 29.
In 2020, firearm injuries became the leading cause of death in children and adolescents and have continued to increase despite injury prevention strategies. The information obtained about these injuries is often limited to the demographic and clinical data required for trauma registries, which often lack granularity regarding the circumstances leading to the use of a firearm. The purpose of this study is to analyze admissions for firearm injuries according to intention and social vulnerability to enable the creation of targeted prevention strategies.
This is a retrospective cohort study using trauma registry data from a single institution from 2012 to 2022. Patients were stratified by a mechanism into unintentional, intentional, and self-inflicted firearm injuries based on chart review. Demographics were compared between groups and the overall trauma population. Social Vulnerability Index data were obtained from the Centers for Disease Control and Prevention registry.
Of the 13,197 trauma patients admitted from January 2012 to December 2022, 153 were related to firearm injuries (1.2%). Relative to the overall trauma population, patients with firearm injuries were predominantly older (9.7 versus 7.4 y, P < 0.001), male (74% versus 61%, P < 0.001), Black (43% versus 17%, P < 0.001), and insured via Medicaid or another government subsidized program (62% versus 48%, P < 0.001). Injuries were classified as intentional (53%), unintentional (44%), and self-harm (1%). Unintentional injuries more frequently resulted in death (17.6% versus 8.6%), although this difference was not enough to reach the statistical significance. The proportion of intentional injuries increased significantly in the 2020-2022 period relative to previous years (P = 0.032).
Vulnerable populations have experienced a disproportionate increase in firearm violence starting in 2020. Unintentional injuries are a significant source of mortality in the pediatric population and represent a vital target for future injury prevention strategies.
2020年，枪支伤害成为儿童和青少年的首要死因，尽管有伤害预防策略，但枪支伤害仍持续增加。关于这些伤害所获取的信息通常仅限于创伤登记所需的人口统计学和临床数据，而这些数据往往缺乏导致使用枪支情况的详细信息。本研究的目的是根据意图和社会脆弱性分析枪支伤害的入院情况，以便制定有针对性的预防策略。
这是一项回顾性队列研究，使用了2012年至2022年来自单一机构的创伤登记数据。通过病历审查，根据机制将患者分为非故意、故意和自残性枪支伤害。比较了各亚组与总体创伤人群的人口统计学特征。社会脆弱性指数数据来自疾病控制和预防中心登记处。
在2012年1月至2022年12月收治的13197例创伤患者中，153例与枪支伤害有关（1.2%）。与总体创伤人群相比，枪支伤害患者主要为年龄较大者（9.7岁对7.4岁，P<0.001）、男性（74%对61%，P<0.001）、黑人（43%对17%，P<0.001），且通过医疗补助或其他政府补贴项目参保（6
