Related Experiment Video
Updated: Aug 20, 2025
A Pediatric Concussion Model in Mice: Closed Head Injury with Long-Term Disorders (CHILD)
Published on: February 7, 2025
Rising Mortality in Pediatric Self-Inflicted Firearm Trauma Associated With Distinct Anatomic Injury
Lea Hoefer1, Adrian Camarena2, Kelly Twohig1
1University of Chicago, Department of Surgery, Chicago, Illinois.
Insights
Self-inflicted firearm trauma (SIFT) in pediatric patients has increased significantly, disproportionately affecting Caucasian males and teenagers. Higher injury severity and head wounds are linked to increased mortality rates.
Area of Science:
- Trauma Surgery
- Pediatric Mortality
- Public Health
Background:
- Self-inflicted injuries are a leading cause of death in adolescents.
- Self-inflicted firearm trauma (SIFT) accounts for a substantial portion of these deaths.
- The study investigates trends and risk factors associated with pediatric SIFT.
Purpose of the Study:
- To determine the prevalence and temporal trends of SIFT in pediatric patients.
- To identify demographic, injury pattern, and outcome associations with SIFT.
- To analyze factors influencing mortality in pediatric firearm trauma.
Main Methods:
- Analysis of the 2007-2018 American College of Surgeons Trauma Quality Programs Participant Use Files.
- Inclusion of pediatric firearm trauma victims (ages 1-17).
- Statistical analysis including chi-squared tests, t-tests, ANCOVA, and multivariate logistic regression (P < 0.05).
Main Results:
- SIFT incidence increased from 2007 to 2018 (P < 0.05).
- SIFT was associated with Caucasian race, teenage males, and higher Injury Severity Scores (ISS).
- Mortality rate for SIFT was 44%, with head wounds and ISS significantly predicting death.
Conclusions:
- SIFT is an increasing public health concern in pediatric populations.
- Policy changes addressing firearm access and pediatric mental health are recommended.
- Interventions are crucial to mitigate SIFT incidence and mortality.
Introduction:
Self-inflicted injuries are the second leading cause of pediatric (10-18 y old) mortality. Self-inflicted firearm trauma (SIFT) was responsible for up to half of these deaths in certain age groups. We hypothesized that SIFT prevalence has increased and is associated with specific demographics, injury patterns, and outcomes.
Materials And Methods:
Data were abstracted from the 2007-2018 American College of Surgeons (ACS) Trauma Quality Programs Participant Use Files (TQP-PUF). Pediatric (1-17 yold) victims of firearm violence were eligible. Age, race, gender, anatomic region, and intent were abstracted. Variables were analyzed using chi-squared tests, t-tests, and single-variate linear regression models. Temporal trends were analyzed using ANCOVA tests. Multivariate logistic regressions were conducted to identify factors influencing mortality. Significance was P < 0.05.
Results:
There were 41,239 pediatric firearm trauma patients (SIFT: 5.5% [n = 2272]). SIFT incidence increased over the 12-y period (2007 (n = 67) versus 2018 (n = 232), P < 0.05). SIFT was significantly associated with Caucasian race, 67% (n = 1537), teenagers, 90% (n = 2056), male gender, 87% (n = 1978), and a higher median injury severity score (ISS) than other intents of injury (SIFT: 20.0 (IQR: 9.0, 25.0) versus other: 9.0 (IQR: 1.0-13.0), P < 0.001). The SIFT mortality rate was 44% (n = 1005). On multivariate regression head gunshot wounds (OR: 21.1, 95% C.I.: 9.9-45.2, P = 0.001), and ISS (OR:1.1, 95% C.I.: 1.1-1.1, P = 0.001) were significantly associated with mortality. Compared to other intents, SIFT mortality rates increased at a higher annual rate (P < 0.001).
Conclusions:
Comprehensive local and federal policy changes to reduce firearms access and increase pediatric mental health support may mitigate these injuries.
