Gunshot Injuries in Children Served by Emergency Services
OBJECTIVE: To describe the incidence, injury severity, resource use, mortality, and costs for children with gunshot injuries, compared with other injury mechanisms.
METHODS: This was a population-based, retrospective cohort study (January 1, 2006–December 31, 2008) including all injured children age ≤19 years with a 9-1-1 response from 47 emergency medical services agencies transporting to 93 hospitals in 5 regions of the western United States. Outcomes included population-adjusted incidence, injury severity score ≥16, major surgery, blood transfusion, mortality, and average per-patient acute care costs.
RESULTS: A total of 49 983 injured children had a 9-1-1 emergency medical services response, including 505 (1.0%) with gunshot injuries (83.2% age 15–19 years, 84.5% male). The population-adjusted annual incidence of gunshot injuries was 7.5 cases/100 000 children, which varied 16-fold between regions. Compared with children who had other mechanisms of injury, those injured by gunshot had the highest proportion of serious injuries (23%, 95% confidence interval [CI] 17.6–28.4), major surgery (32%, 95% CI 26.1–38.5), in-hospital mortality (8.0%, 95% CI 4.7–11.4), and costs ($28 510 per patient, 95% CI 22 193–34 827).
CONCLUSIONS: Despite being less common than other injury mechanisms, gunshot injuries cause a disproportionate burden of adverse outcomes in children, particularly among older adolescent males. Public health, injury prevention, and health policy solutions are needed to reduce gunshot injuries in children.
- AIS —
- abbreviated injury scale
- CI —
- confidence interval
- ED —
- emergency department
- EMS —
- emergency medical services
- GCS —
- Glasgow Coma Scale
- ICD-9-CM —
- International Classification of Diseases, Ninth Revision, Clinical Modification
- ISS —
- injury severity score
- WESTRN —
- Western Emergency Services Translational Research Network
- Accepted August 7, 2013.
- Copyright © 2013 by the American Academy of Pediatrics