Sawaya Jessica, McRae Joyce J L H, Mladenov Georgi, Larson Joseph Michael, Radulescu Andrei, Minasian Tanya
Loma Linda University School of Medicine, Loma Linda, United States.
Department of General Surgery, Division of Pediatric Surgery, Loma Linda University Health, Loma Linda, United States.
Surg Neurol Int. 2024 Nov 8;15:405. doi: 10.25259/SNI_717_2024. eCollection 2024.
The United States (US) has one of the highest rates of gunshot-related incidents in the world. Gunshot wounds to the head (GSWH) in the pediatric population are also common, with high morbidity and mortality rates.
We performed a retrospective study to analyze if there was a notable change in trends in pediatric GSWH at our Level 1 Pediatric Trauma Center due to the COVID-19 pandemic. A retrospective study was conducted including patients under the age of 18 presenting with GSWH from January 2014 to May 2023. Variables assessed included demographics, interventions, and outcomes. Data from the county's Child Death Review Team Annual Report on mortality related to gunshot-related deaths from January 2014 to June 2023 were analyzed.
In total, thirty-five patients were evaluated at our institution for GSWH. Nineteen patients were treated during the 6 years before the pandemic and sixteen during the 3-year pandemic. Nine patients died at the hospital, with an overall increase during the pandemic. In the county, seventy-two children were killed from gun violence, with 58% (42) from GSWH. Death from GSWH increased in the county cohort during the pandemic.
The pandemic affected the outcomes of patients with GSWH at our institution with an overall increase in rates of self-inflicted and drive-by shootings, a doubling of neurosurgical interventions, an increase in acuity of care for long-term disposition, and an increase in mortality. At a county level, there was an increase in overall deaths from GSWHs, the majority of which were nonaccidental.
美国是世界上与枪击相关事件发生率最高的国家之一。儿科人群的头部枪伤（GSWH）也很常见，发病率和死亡率都很高。
我们进行了一项回顾性研究，以分析由于新冠疫情，我们的一级儿科创伤中心儿科GSWH的趋势是否有显著变化。进行了一项回顾性研究，纳入了2014年1月至2023年5月期间出现GSWH的18岁以下患者。评估的变量包括人口统计学、干预措施和结果。分析了该县儿童死亡审查小组2014年1月至2023年6月关于与枪击相关死亡的年度报告中的数据。
我们机构共评估了35例GSWH患者。疫情前6年有19例患者接受治疗，疫情3年期间有16例。9例患者在医院死亡，疫情期间总体有所增加。在该县，72名儿童死于枪支暴力，其中58%（42例）死于GSWH。在该县队列中，疫情期间GSWH导致的死亡有所增加。
疫情影响了我们机构GSWH患者的治疗结果，自我伤害和驾车枪击发生率总体上升，神经外科干预增加了一倍，长期处置的护理 acuity增加，死亡率上升。在县一级，GSWH导致的总体死亡有所增加，其中大多数是非意外死亡。
