Pediatric unintentional firearm injuries in rural trauma

Abstract

PURPOSE of Study Gunshot wounds are the second most common cause of traumatic pediatric deaths in the US, with greater risk than other developed countries. We sought to determine the clinical trends and geographical and age foci associated with unintentional pediatric (UGSWs). Methods Used We identified pediatric patients (≤18 years old) admitted for UGSWs (2000-2015). Patients were stratified by age: Summary of Results 194 children (79.4% male, 72.0% African American) sustained UGSWs, mean age of 10.7 ±4.6 years. Most common firearms were handguns, pellet guns, and hunting rifle (54.2%, 24.7% and 5.3%, respectively). UGSWs had a mortality rate of 4.1%, similar to the US rate of 5.0%. Mean hospital stay was 4.7 days, with median Injury Severity Score (ISS) of 5 (Range 1-13) and most common injury site being the extremity. Young teenagers (10-14 years) had rates of UGSW twice that of other age groups. Younger age groups had higher mean ISS (15.8 vs. 10.8 vs. 9.0 vs. 5.7, p=0.011), with no difference in mortality rates (p=0.898) or length of hospitalization (p=0.449). The youngest patients suffered more injuries to head/neck and abdominal cavity, while young teenagers were more commonly shot in the extremities and older teenagers had more thoracic trauma. Geographiccally, UGSW rates increased in peri-urban areas (Fig). Conclusions Children 10-14 years old in peri-urban are most likely to experience UGSWs with handguns. Using the resulting heat maps we established the most effective areas and populations for preventative intervention. Abstract from: Southern Regional Meeting 2017, New Orleans, LA, February 11-13, 2017 Language: en