A Comparative Analysis of Zip Code Discordance in Pediatric Gunshot Wounds.

Area of Science:

• Trauma Surgery
• Pediatric Emergency Medicine
• Public Health

Background:

• Pediatric gun violence is a growing concern, necessitating evaluation of trauma care interventions.
• Traditional trauma research often uses residence zip codes as a proxy for injury zip codes.
• This study specifically examines zip code discordance in pediatric gunshot wound patients.

Purpose of the Study:

• To investigate the relationship between zip code of injury and zip code of residence in pediatric gunshot wound patients.
• To determine if zip code discordance (ZCD) is associated with clinical outcomes in this population.

Main Methods:

• Retrospective review of trauma registries from a children's and an adult hospital.
• Included pediatric patients (<15 years) with gunshot wounds (Jan 2016-Apr 2023).
• Defined and analyzed zip code discordance (ZCD) against clinical variables.

Main Results:

• Zip code discordance (ZCD) was present in 40.3% of 238 pediatric gunshot wound patients.
• Black patients showed a significantly higher prevalence of ZCD (92.7% vs. 79.6%).
• ZCD was associated with longer hospital length of stay (OR 1.41) and increased mortality risk (OR 6.79).

Conclusions:

• Significant differences exist between pediatric patients with and without ZCD.
• Accurate zip code data is vital for effective pediatric trauma care and research.
• Further investigation is needed to understand the mechanisms behind ZCD's impact on clinical outcomes.