Defining the Full Spectrum of Pediatric Firearm Injury and Death in the United States: It is Even Worse Than We Think.
Journal
Annals of surgery
ISSN: 1528-1140
Titre abrégé: Ann Surg
Pays: United States
ID NLM: 0372354
Informations de publication
Date de publication:
01 07 2023
01 07 2023
Historique:
medline:
12
6
2023
pubmed:
25
2
2023
entrez:
24
2
2023
Statut:
ppublish
Résumé
To characterize the full spectrum of pediatric firearm injury in the United States by describing fatal and nonfatal injury data epidemiology, vulnerable populations, and temporal trends. Firearm injury is the leading cause of death in children and adolescents in the United States. Nonfatal injury is critical to fully define the problem, yet accurate data at the national level are lacking. A cross-sectional study combining national firearm injury data from the Centers for Disease Control (fatal) and the National Trauma Data Bank (nonfatal) between 2008 and 2019 for ages 0 to 17 years. Data were analyzed using descriptive and χ 2 comparisons and linear regression. Approximately 5000 children and adolescents are injured or killed by firearms each year. Nonfatal injuries are twice as common as fatal injuries. Assault accounts for the majority of injuries and deaths (67%), unintentional 15%, and self-harm 14%. Black youth suffer disproportionally higher injuries overall (crude rate: 49.43/million vs White, non-Hispanic: 15.76/million), but self-harm is highest in White youth. Children <12 years are most affected by nonfatal unintentional injuries, 12 to 14 years by suicide, and 15 to 17 years by assault. Nonfatal unintentional and assault injuries, homicides, and suicides have all increased significantly ( P < 0.05). This study adds critical and contemporary data regarding the full spectrum and recent trends of pediatric firearm injury in the United States and identifies vulnerable populations to inform injury prevention intervention and policy. Reliable national surveillance for nonfatal pediatric firearm injury is vital to accurately define and tackle this growing public health crisis.
Sections du résumé
OBJECTIVE
To characterize the full spectrum of pediatric firearm injury in the United States by describing fatal and nonfatal injury data epidemiology, vulnerable populations, and temporal trends.
BACKGROUND
Firearm injury is the leading cause of death in children and adolescents in the United States. Nonfatal injury is critical to fully define the problem, yet accurate data at the national level are lacking.
METHODS
A cross-sectional study combining national firearm injury data from the Centers for Disease Control (fatal) and the National Trauma Data Bank (nonfatal) between 2008 and 2019 for ages 0 to 17 years. Data were analyzed using descriptive and χ 2 comparisons and linear regression.
RESULTS
Approximately 5000 children and adolescents are injured or killed by firearms each year. Nonfatal injuries are twice as common as fatal injuries. Assault accounts for the majority of injuries and deaths (67%), unintentional 15%, and self-harm 14%. Black youth suffer disproportionally higher injuries overall (crude rate: 49.43/million vs White, non-Hispanic: 15.76/million), but self-harm is highest in White youth. Children <12 years are most affected by nonfatal unintentional injuries, 12 to 14 years by suicide, and 15 to 17 years by assault. Nonfatal unintentional and assault injuries, homicides, and suicides have all increased significantly ( P < 0.05).
CONCLUSIONS
This study adds critical and contemporary data regarding the full spectrum and recent trends of pediatric firearm injury in the United States and identifies vulnerable populations to inform injury prevention intervention and policy. Reliable national surveillance for nonfatal pediatric firearm injury is vital to accurately define and tackle this growing public health crisis.
Identifiants
pubmed: 36825500
doi: 10.1097/SLA.0000000000005833
pii: 00000658-202307000-00003
pmc: PMC10249597
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
10-16Informations de copyright
Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.
Déclaration de conflit d'intérêts
The authors report no conflicts of interest.
Références
Andrews AL, Killings X, Oddo ER, et al. Pediatric firearm injury mortality epidemiology. J Pediatr. 2022;149:e2021052739.
Grinshteyn E, Hemenway D. Violent death rates in the US compared to those of the other high-income countries. Prev Med. 2019;123:20–26.
Espitia‐Hardeman V, Paulozzi L. Injury Surveillance Training Manual. Atlanta (GA): centers for Disease Control and Prevention. Nat Center Inj Prev Control. 2005:1–173.
Sidhu S, Mandelbaum A, Dobaria V, et al. National trends in the cost burden of pediatric gunshot wounds across the United States. J Pediatr. 2021;236:172–178.
Kaufman EJ, Wiebe DJ, Xiong RA, et al. Epidemiologic trends in fatal and nonfatal firearm injuries in the US, 2009-2017. JAMA Intl Med. 2021;181:237.
DiScala C, Sege R. Outcomes in children and young adults who are hospitalized for firearms-related injuries. J Pediatr. 2004;113:1306–1312.
Ranney M, Karb R, Ehrlich P, et al. for the FACTS Consortium.. What are the long-term consequences of youth exposure to firearm injury, and how do we prevent them? A scoping review. J Behav Med. 2019;42:724–740.
Taylor JS, Madhavan S, Han RW, et al. Financial burden of pediatric firearm-related injury admissions in the United States. PLoS One. 2021;16:e0252821.
Centers for Disease Control, National Center for Injury Prevention & Control. WISQARSTM – Web-based Injury Statistics Query and Reporting System. Updated February 2, 2021. Accessed December 1, 2022. https://www.cdc.gov/injury/wisqars/index.html
Barber C, Cook PJ, Parker ST. The emerging infrastructure of US firearms injury data. Prev Med. 2022;165:107129.
Coupet E, Huang Y, Delgado MK. US emergency department encounters for firearm injuries according to presentation at trauma vs nontrauma centers. JAMA Surg. 2019;154:360.
American College of Surgeons. Trauma Program: About NTDB. Accessed November 16, 2021. https://www.facs.org/quality-programs/trauma/quality/national-trauma-data-bank/about-ntdb/
Goldstick JE, Cunningham RM, Carter PM. Current causes of death in children and adolescents in the United States. N Engl J Med. 2022;386:1955–1956.
O’Neill B, Mohan D. Preventing motor vehicle crash injuries and deaths: science vs. folklore lessons from history. Int J Inj Contr Saf Promot. 2020;27:3–11.
Gun violence archive. Washington, DC. Updated March 1, 2023. Accessed March 1, 2023. https://www.gunviolencearchive.org/
Esparaz JR, Waters AM, Mathis MS, et al. The disturbing findings of pediatric firearm injuries from the National Trauma Data Bank: 2010-2016. J Surg Res. 2021;259:224–229.
Olufajo OA, Zeineddin A, Nonez H, et al. Trends in firearm injuries among children and teenagers in the United States. J Surg Res. 2020;245:529–536.
Carr B, Bowman A, Wolff C, et al. Disparities in access to trauma care in the United States: a population-based analysis. Injury. 2017;48:332–338.
Barber C, Goralnick E, Miller M. The problem with ICD-coded firearm injuries. JAMA Intern Med. 2021;181:1132–1133.
Donnelly KA, Badolato GM, Goyal MK. Determining intentionality of pediatric firearm injuries by International Classification of Disease Code. Pediatr Emerg Care. 2022;38:e306–e309.
Fowler KA, Dahlberg LL, Haileyesus T, et al. Childhood firearm injuries in the United States. Pediatrics. 2017;140:1–19.
Nonfatal injury data. Centers for Disease Control, National Center for Injury Prevention & Control website. Accessed February 10, 2022; Accessed July 1, 2022. https://www.cdc.gov/injury/wisqars/nonfatal.html
Bates J Mass shootings are only a small part of America’s deadly problem with kids and guns [Time Magazine web site], June 3, 2022. Accessed August 19, 2022. https://time.com/6182856/children-gun-deaths-mass-shootings/
Sheats KJ. Violence-related disparities experienced by black youth and young adults: opportunities for prevention. Am J Prev Med. 2018;55:462–469.
El Ibrahimi S, Xiao Y, Bergeron CD, et al. Suicide distribution and trends among male older adults in the U.S., 1999-2018. Am J Prev Med. 2021;60:802–811.
Ramchand R, Gordon JA, Pearson JL. Trends in suicide rates by race and ethnicity in the United States. JAMA Netw Open. 2021;4:e2111563.
Mpofu JJ, Crosby A, Flynn MA, et al. Preventing suicidal behavior among American Indian and Alaska Native adolescents and young adults [published online July 20, 2022]. Public Health Rep. doi: 10.1177/00333549221108986. https://journals.sagepub.com/doi/10.1177/00333549221108986
doi: 10.1177/00333549221108986
Crifasi CK, Doucette ML, McGinty EE, et al. Storage practices of US gun owners in 2016. Am J Public Health. 2018;108:532–537.
Brent DA, Perper JA, Moritz G, et al. Firearms, and adolescent suicide. A community case-control study. Am J Dis Child. 1993;147:1066–1071.
Grossman DC, Mueller BA, Riedy C, et al. Gun storage practices and risk of youth suicide and unintentional firearm injuries. JAMA. 2005;293:707–714.
Hamilton EC, Miller CC, Cox CS, et al. Variability of child access prevention laws and pediatric firearm injuries. J Trauma Acute Care Surg. 2018;84:613–619.
Kalesan B, Mobily ME, Keiser O, et al. Firearm legislation and firearm mortality in the USA: a cross-sectional, state-level study. Lancet. 2016;387:1847–1855.
Carpenito T, Miller M, Manjourides J, et al. Using multiple imputation by super learning to assign intent to nonfatal firearm injuries. Prev Med. 2022;163:107183.