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Twenty years of pediatric gunshot wounds: an urban trauma center's experience
James S Davis1, Diego M Castilla, Carl I Schulman
1Department of Surgery, University of Miami Miller School of Medicine, Miami, Florida 33101, USA.
Insights
Pediatric gunshot wounds are a significant public health issue. This study reveals increasing injury rates and identifies key demographic and injury location trends in urban children.
Area of Science:
- Trauma Surgery
- Pediatric Emergency Medicine
- Public Health
Background:
- Pediatric gunshot wounds (GSW) contribute significantly to child morbidity and mortality in the U.S.
- Limited data exists on recent GSW trends in urban pediatric populations.
Purpose of the Study:
- To document demographic, injury, and outcome trends of pediatric GSW.
- To analyze temporal changes in pediatric GSW incidence.
Main Methods:
- Retrospective review of a trauma registry (1991-2011).
- Inclusion criteria: pediatric patients (0-16 years) with GSW.
- Statistical analysis included descriptive statistics and chi-squared tests.
Main Results:
- 740 pediatric GSW patients treated.
- Predominant demographics: male (82%), African American (72%).
- Most common injury sites: abdomen, back, pelvis (26%). Head/neck injuries had highest mortality (35%); overall mortality 12.7%.
- Pediatric GSW incidence, after a decline in the 1990s, is increasing.
Conclusions:
- Identified demographic and temporal trends in pediatric GSW.
- Overall incidence of pediatric gunshot wounds is rising, highlighting an urgent public health concern.
Background:
Pediatric gunshot wounds remain an important cause of morbidity and mortality in the United States. Recent experience in the urban pediatric population has not been extensively documented.
Methods:
A retrospective review of the trauma registry identified all pediatric (age 0-16 y) gunshot wound injuries between October 1991 and August 2011. We evaluated demographic, injury location, disposition, and outcome data. We applied descriptive statistics and χ(2) with significance level set to P ≤ 0.05.
Results:
We treated 740 patients at our trauma center. Patients tended to be male (82%) and African American (72%), and most frequently were shot in the abdomen, back, or pelvic regions (26%). Patients with head or neck injuries experienced the highest mortality rate (35%), whereas the mortality rate overall was 12.7%. A total of 23% of patients were discharged directly, but 32% required an operation. We grouped data into five equal time periods, demonstrating that after decreasing through the 1990s, pediatric gunshot wounds presenting to our hospital are steadily increasing.
Conclusions:
We identified certain demographic and temporal trends regarding pediatric gunshot wounds, and the overall number of injuries appears to be increasing.
