Rising Mortality in Pediatric Self-Inflicted Firearm Trauma Associated With Distinct Anatomic Injury.
J Surg Res
; 283: 259-265, 2023 Mar.
Article
em En
| MEDLINE
| ID: mdl-36423474
ABSTRACT
INTRODUCTION:
Self-inflicted injuries are the second leading cause of pediatric (10-18 y old) mortality. Self-inflicted firearm trauma (SIFT) was responsible for up to half of these deaths in certain age groups. We hypothesized that SIFT prevalence has increased and is associated with specific demographics, injury patterns, and outcomes. MATERIALS ANDMETHODS:
Data were abstracted from the 2007-2018 American College of Surgeons (ACS) Trauma Quality Programs Participant Use Files (TQP-PUF). Pediatric (1-17 yold) victims of firearm violence were eligible. Age, race, gender, anatomic region, and intent were abstracted. Variables were analyzed using chi-squared tests, t-tests, and single-variate linear regression models. Temporal trends were analyzed using ANCOVA tests. Multivariate logistic regressions were conducted to identify factors influencing mortality. Significance was P < 0.05.RESULTS:
There were 41,239 pediatric firearm trauma patients (SIFT 5.5% [n = 2272]). SIFT incidence increased over the 12-y period (2007 (n = 67) versus 2018 (n = 232), P < 0.05). SIFT was significantly associated with Caucasian race, 67% (n = 1537), teenagers, 90% (n = 2056), male gender, 87% (n = 1978), and a higher median injury severity score (ISS) than other intents of injury (SIFT 20.0 (IQR 9.0, 25.0) versus other 9.0 (IQR 1.0-13.0), P < 0.001). The SIFT mortality rate was 44% (n = 1005). On multivariate regression head gunshot wounds (OR 21.1, 95% C.I. 9.9-45.2, P = 0.001), and ISS (OR1.1, 95% C.I. 1.1-1.1, P = 0.001) were significantly associated with mortality. Compared to other intents, SIFT mortality rates increased at a higher annual rate (P < 0.001).CONCLUSIONS:
Comprehensive local and federal policy changes to reduce firearms access and increase pediatric mental health support may mitigate these injuries.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Ferimentos por Arma de Fogo
/
Armas de Fogo
Tipo de estudo:
Prognostic_studies
/
Risk_factors_studies
Limite:
Adolescent
/
Child
/
Humans
/
Male
Idioma:
En
Revista:
J Surg Res
Ano de publicação:
2023
Tipo de documento:
Article