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Outcomes of Children With Firearm Injuries Admitted to the PICU in the United States

Dayanand Bagdure1, Cortney B Foster1, Nan Garber1

  • 1Department of Pediatrics, Division of Critical Care Medicine, University of Maryland School of Medicine, Baltimore, MD.

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
|June 6, 2021
PubMed

Insights

Firearm injuries are a leading cause of death for US children, with a high mortality rate in pediatric intensive care units (PICUs). Suicide attempts by firearm carry the highest mortality risk for pediatric patients.

Area of Science:

  • Pediatric critical care medicine
  • Public health
  • Trauma surgery

Background:

  • Firearm-related injuries rank as the second leading cause of death for children aged 1-18 in the United States.
  • Pediatric intensive care units (PICUs) manage severe cases of pediatric firearm injuries.

Purpose of the Study:

  • To analyze the outcomes of children admitted to the PICU following firearm-related injuries.
  • To identify risk factors and patterns associated with pediatric firearm injury mortality and morbidity.

Main Methods:

  • A retrospective study was conducted using data from US PICUs contributing to Virtual Pediatric Systems, LLC, between January 2009 and December 2017.
  • Cases were identified using International Classification of Diseases (ICD) codes for firearm injuries in children aged 1 month to 18 years.

Main Results:

  • A total of 1,447 pediatric firearm injury cases were identified, with a mortality rate of 12% (175 deaths).
  • Unintentional firearm injuries (67.7%) and assaults (20%) constituted 90% of cases; males (78%) and Black children (45%) were disproportionately represented.
  • Children aged 13-18 years accounted for 55% of PICU deaths, and those with suicide attempts had significantly higher mortality compared to other injury types.
  • High morbidity was observed based on Pediatric Overall Performance Category and Pediatric Cerebral Performance Category scores at discharge.

Conclusions:

  • The mortality rate for children with firearm injuries admitted to the PICU is notably high.
  • Firearm-related suicide attempts in children are associated with the highest mortality within the PICU setting.
  • Further research into the epidemiology of pediatric firearm injuries is crucial for developing effective interventions to reduce preventable deaths.
Abstract

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