Pediatric Head and Neck Gunshot Wounds in the United States: A Cohort Study

Abstract

Objectives: Study head and neck gunshot wounds (GSW) involving pediatric patients in the United States. Methods: Study Design: Retrospective cohort study. Setting: The KIDS Inpatient Database (KID) years 2003, 2006, and 2009. The subpopulation of pediatric patients 21 years and younger admitted with head and neck trauma due to gunshot wounds were compared with all patients admitted with head and neck traumatic injuries. Univariate and multivariate analysis was completed to evaluate demographics, morbidity, and mortality associated with gunshot wounds to the head and neck. Age, sex, and ethnic disparities were also examined. Results: An estimated 1342 (SE, 100.7) pediatric patients suffered gun shot wounds to the head and neck, 3.2% (SE, 0.19) of all head and neck traumatic wounds. The mean age was 17.1 years (SE 0.12). The population was 88.1 % male (SE, 1.1), 48.2% (SE, 2.9) black, and 10.2% (SE, 1.1) died during their hospitalization. Mean total charges were $70,312 (SE, $4216). When compared with the larger population of pediatric head and neck trauma patients, GSW patients were statistically significantly older, male, black, and living in the lowest income quartile (all P < .01). Additionally, GSW patients had longer hospital stays, higher total charges, and higher mortality rates. These findings held constant when controlling for age, sex, and injury severity/mortality risk. Conclusions: Gunshot wounds to the head and neck are an uncommon but serious injury in pediatric patients. Continued research regarding treatment and prevention is warranted.