Critical care resource use, cost, and mortality associated with firearm-related injuries in US children's hospitals

Area of Science:

• Pediatric Critical Care Medicine
• Public Health
• Trauma Surgery

Background:

• Firearm-related injuries represent a significant public health concern in the United States.
• Pediatric intensive care units (PICUs) manage severe cases of pediatric firearm injuries.
• Understanding resource utilization is crucial for healthcare planning and intervention.

Purpose of the Study:

• To evaluate trends in pediatric firearm injury admissions to PICUs.
• To assess the associated resource utilization and costs in PICUs.
• To identify changes in treatment modalities and outcomes over time.

Main Methods:

• Retrospective cohort study utilizing data from the Pediatric Health Information Systems (PHIS) database.
• Analysis of admissions to 28 children's hospitals between 2004 and 2017.
• Examination of PICU length of stay, costs, interventions, and mortality rates.

Main Results:

• Of nearly 6 million admissions, 3,707 were for firearm injuries, with 1,088 requiring PICU admission.
• PICU costs significantly increased, with a median of $37,569.31 per hospitalization.
• Increased use of mechanical ventilation (61.9%), surgical procedures (68.3%), blood transfusions (39.9%), and CT scans was observed.

Conclusions:

• Pediatric firearm injuries place a substantial burden on PICU resources, marked by rising costs and increased utilization of critical care interventions.
• There was a notable increase in the frequency of invasive mechanical ventilation, neuromonitoring, surgical procedures, and blood product transfusions.
• Continued research is essential to fully characterize the impact and burden of pediatric firearm injuries in critical care settings.