Twenty years of pediatric gunshot wounds in our community: Have we made a difference?
J Pediatr Surg
; 54(1): 160-164, 2019 Jan.
Article
em En
| MEDLINE
| ID: mdl-30482538
ABSTRACT
BACKGROUND/PURPOSE:
Pediatric gunshot wounds (GSWs) carry significant incidence, mortality, and cost. We evaluated 20â¯years of GSW demographics at this level 1 trauma center and constructed a risk map triangulating areas of high incidence with risk factors.METHODS:
Children 0-18â¯years suffering a GSW between 1996 and 2016 were identified via our trauma registry. Hospital charges, demographic, socioeconomic, and institutional variables were retrospectively reviewed. Multivariable logistic regression identified predictors of mortality. Geographic information system (GIS) mapping of incident location and residence identified areas of higher incidence.RESULTS:
The cohort (nâ¯=â¯898) was 86.4% male. Mean age was 15.6⯱â¯3.4â¯years. Median Injury Severity Score (ISS) was 9 (1-75). Procedural and/or operative intervention occurred in 52.9%. Intent included assault (81.5%) and unintentional injury (12.8%). Hospital charges showed significant annual increase. Annual incidence varied without trend (pâ¯=â¯0.89). Mapping revealed significant clustering of GSWs in known lower socioeconomic areas. Yearly and total GSWs were highest in one particular zip code. ISS was a significant predictor of mortality (nâ¯=â¯18) (OR 1.19, 95% CI 1.15-1.22, pâ¯<â¯0.001).CONCLUSIONS:
Our impoverished neighborhoods have higher pediatric GSW incidence, unchanged over 20â¯years. Alternative community-based prevention efforts should involve neighborhood capacity building and economic strengthening. TYPE OF STUDY Retrospective study. LEVEL OF EVIDENCE Level IV.Palavras-chave
Texto completo:
1
Temas:
ECOS
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Aspectos_gerais
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Financiamentos_gastos
Bases de dados:
MEDLINE
Assunto principal:
Ferimentos por Arma de Fogo
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Violência com Arma de Fogo
Tipo de estudo:
Etiology_studies
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Health_economic_evaluation
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Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adolescent
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Adult
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Child
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Child, preschool
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Female
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Humans
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Infant
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Male
País/Região como assunto:
America do norte
Idioma:
En
Revista:
J Pediatr Surg
Ano de publicação:
2019
Tipo de documento:
Article