Li G, Baker S P, DiScala C, Fowler C, Ling J, Kelen G D
Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Md, USA.
Arch Pediatr Adolesc Med. 1996 Nov;150(11):1160-5. doi: 10.1001/archpedi.1996.02170360050008.
To examine the characteristics of unintentional and assaultive firearm-related pediatric injuries treated in trauma centers.
Comparative analysis of patients 14 years or younger who were admitted to the trauma centers because of unintentional firearm-related injuries (n = 292) vs assaultive firearm-related injuries (n = 457).
Sixty-eight trauma centers or children's hospitals in the continental United States and Canada that reported data to the National Pediatric Trauma Registry from January 1, 1990, through December 31, 1994.
Frequency distributions of firearm-related injuries in relation to intent and injury circumstances, odds ratios (ORs) on the intent of injury being assaultive, injury severity scales, and in-hospital fatality rates.
The frequency of unintentional firearm-related injuries rose in the afternoons peaking between 4 and 5 PM; they predominantly occurred at home (89%). Assaultive firearm-related injuries peaked sharply between 8 and 9 PM and usually occurred on roads or in other public places (63%). About 3 times as many boys as girls were harmed in firearm-related injuries. Given a firearm-related injury resulting in admission to a trauma center, the adjusted OR of it being assaultive was 2.8 (95% confidence interval [CI], 1.6-4.6) if the victim was a girl, 4.9 (95% CI, 3.1-7.8) if the shooting occurred at night, 2.6 (95% CI, 1.6-4.2) if the shooting occurred on a weekday, and 21.1 (95% CI, 9.1-49.4) if the shooting occurred on a road. Injury patterns and severity were similar between patients with unintentional and assaultive injuries. Overall, 19% of the patients sustained head injuries, which contributed to 90% of the in-hospital deaths.
Marked differences in injury circumstances exist between unintentional and assaultive firearm-related injuries among children. The late afternoon hours when many children have come home from school but their parents may still be working have the highest frequency of unintentional firearm-related injuries. The evening peak of assaultive injuries may be related to drug-related and gang-related violence. While it is important to reduce the access of firearms to children, school-based extracurricular and community-based social services should be considered in developing intervention programs.
研究创伤中心收治的与枪支相关的儿童意外伤害和攻击性伤害的特征。
对因与枪支相关的意外伤害（n = 292）或攻击性伤害（n = 457）而入住创伤中心的14岁及以下患者进行对比分析。
美国大陆和加拿大的68家创伤中心或儿童医院，这些机构在1990年1月1日至1994年12月31日期间向国家儿科创伤登记处报告了数据。
与枪支相关伤害的频率分布与伤害意图及伤害情况的关系、伤害意图为攻击性的优势比（OR）、伤害严重程度量表以及院内死亡率。
与枪支相关的意外伤害频率在下午上升，在下午4点至5点达到峰值；主要发生在家中（89%）。与枪支相关的攻击性伤害在晚上8点至9点急剧达到峰值，通常发生在道路或其他公共场所（63%）。在与枪支相关的伤害中，受伤害的男孩数量约为女孩的3倍。对于因与枪支相关的伤害而入住创伤中心的患者，如果受害者是女孩，伤害为攻击性的调整后OR为2.8（95%置信区间[CI]，1.6 - 4.6）；如果枪击发生在夜间，调整后OR为4.9（95%CI，3.1 - 7.8）；如果枪击发生在工作日，调整后OR为2.6（95%CI，1.6 - 4.2）；如果枪击发生在道路上，调整后OR为21.1（95%CI，9.1 - 49.4）。意外伤害和攻击性伤害患者的损伤模式和严重程度相似。总体而言，19%的患者头部受伤，这导致了90%的院内死亡。
儿童中与枪支相关的意外伤害和攻击性伤害在伤害情况上存在显著差异。许多孩子放学回家但父母可能仍在工作的傍晚时分，与枪支相关的意外伤害频率最高。攻击性伤害的晚间峰值可能与毒品相关和帮派相关暴力有关。虽然减少儿童获取枪支的机会很重要，但在制定干预计划时应考虑以学校为基础的课外活动和以社区为基础的社会服务。
