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The COVID-19 pandemic and associated rise in pediatric firearm injuries: A multi-institutional study
Amelia T Collings1, Manzur Farazi2, Kyle J Van Arendonk2
1Department of Surgery, Indiana University, 545 Barnhill Dr., Emerson 125, Indianapolis, IN, United States.
Insights
Pediatric firearm injuries significantly increased during the COVID-19 pandemic. Stay-at-home orders were associated with a rise in child firearm injuries, exceeding historical rates.
Area of Science:
- Public Health
- Trauma Surgery
- Epidemiology
Background:
- Firearm sales surged in the U.S. during the COVID-19 pandemic.
- Pediatric firearm injuries represent a significant public health concern.
- Stay-at-home orders (SHO) were implemented nationwide in response to the pandemic.
Purpose of the Study:
- To investigate the association between pediatric firearm injuries and stay-at-home orders during the COVID-19 pandemic.
- To determine if firearm injury rates in children changed during the pandemic.
- To test the hypothesis of increased pediatric firearm injuries during SHO.
Main Methods:
- Multi-institutional retrospective study utilizing trauma registries.
- Comparison of a COVID cohort (during SHO) with historical controls (2016-2019).
- Interrupted time series analysis (ITSA) to assess injury rate changes post-emergency declaration.
Main Results:
- A significant increase in the proportion of firearm injuries among pediatric trauma patients during the COVID cohort (3.04% vs. 1.83%).
- An 87% increase in the observed rate of pediatric firearm injuries above expected rates following the national emergency declaration.
- A greater cumulative burden of firearm injuries in 2020 compared to historical averages.
Conclusions:
- The proportion of firearm injuries in children rose during the COVID-19 pandemic.
- The pandemic and associated public health measures correlated with an increase in pediatric firearm injuries.
- Pediatric firearm injury rates exceeded expected patterns during the pandemic.
Background:
Firearm sales in the United States (U.S.) markedly increased during the COVID-19 pandemic. Our objective was to determine if firearm injuries in children were associated with stay-at-home orders (SHO) during the COVID-19 pandemic. We hypothesized there would be an increase in pediatric firearm injuries during SHO.
Methods:
This was a multi institutional, retrospective study of institutional trauma registries. Patients <18 years with traumatic injuries meeting National Trauma Data Bank (NTDB) criteria were included. A "COVID" cohort, defined as time from initiation of state SHO through September 30, 2020 was compared to "Historical" controls from an averaged period of corresponding dates in 2016-2019. An interrupted time series analysis (ITSA) was utilized to evaluate the association of the U.S. declaration of a national state of emergency with pediatric firearm injuries.
Results:
Nine Level I pediatric trauma centers were included, contributing 48,111 pediatric trauma patients, of which 1,090 patients (2.3%) suffered firearm injuries. There was a significant increase in the proportion of firearm injuries in the COVID cohort (COVID 3.04% vs. Historical 1.83%; p < 0.001). There was an increased cumulative burden of firearm injuries in 2020 compared to a historical average. ITSA showed an 87% increase in the observed rate of firearm injuries above expected after the declaration of a nationwide emergency (p < 0.001).
Conclusion:
The proportion of firearm injuries affecting children increased during the COVID-19 pandemic. The pandemic was associated with an increase in pediatric firearm injuries above expected rates based on historical patterns.
