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Functional impairment associated with nonfatal pediatric firearm injuries
Caroline G Melhado1, Travis M Sullivan2, Caroline Q Stephens1
1Division of Pediatric Surgery, University of California-San Francisco Benioff Children's Hospitals, and Department of Surgery, University of California-San Francisco, CA.
Surgery
|June 10, 2023
Summary
Pediatric firearm injuries cause significant functional impairment in child survivors. Many children experience lasting mild impairments, underscoring the need to address this public health crisis.
Area of Science:
- Pediatric trauma surgery
- Public health
- Child injury prevention
Background:
- Firearm injury is the leading cause of death for US children.
- Functional morbidity in pediatric firearm injury survivors is a significant public health concern.
- Quantifying functional impairment in pediatric firearm injury survivors is crucial.
Purpose of the Study:
- To assess the prevalence and nature of functional impairment among survivors of pediatric firearm injury.
- To quantify functional morbidity using the Functional Status Scale.
- To evaluate functional status at discharge and follow-up.
Main Methods:
- Retrospective cohort study of children (0-18 years) treated for firearm injuries.
- Analysis of data from 2 urban level 1 pediatric trauma centers (2014-2022).
- Assessment of functional impairment using the Functional Status Scale (FSS) at discharge and follow-up.
Main Results:
- A cohort of 282 children was analyzed, with 7% in-hospital mortality.
- Functional impairment (FSS ≥8) was observed in 9% at discharge and 7% at follow-up.
- Mild impairment (FSS = 7) was common (42% at discharge) and often persisted (67% at follow-up).
Conclusions:
- Functional impairment is common among pediatric firearm injury survivors.
- Non-mortality metrics like functional status are vital for assessing the burden of pediatric firearm injuries.
- Considering both mortality and functional morbidity is essential for advocating child protection resources.
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