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Surgical and Critical Care Resource Utilization After Firearm Injury: An Age-Based Analysis.

Zachary T O'Connor1, Alyssa Green2, Myron L Rolle3

  • 1University of South Florida College of Arts and Sciences, Tampa, Florida.

The Journal of Surgical Research
|August 26, 2025
PubMed
Summary

Firearm injuries frequently require surgery and critical care. Children with firearm injuries are more likely to need central nervous system (CNS) procedures and blood transfusions than adults.

Keywords:
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Area of Science:

  • Trauma Surgery
  • Pediatric Critical Care
  • Public Health

Background:

  • Firearm injuries necessitate urgent surgical and critical care, with varying hospital readiness, especially for pediatric patients.
  • This study examines resource utilization in firearm injuries across different age groups.

Purpose of the Study:

  • To investigate and compare resource utilization in firearm injuries across diverse age demographics.
  • To identify age-specific differences in surgical and critical care interventions.

Main Methods:

  • Analysis of the Florida statewide Agency for Healthcare Administration database (2015-2021) for firearm injury hospitalizations.
  • Categorization of patients by age: children (0-13), young adolescents (14-15), older adolescents (16-17), adults (18-64), and elderly (65+).
  • Comparison of surgical procedure and critical care intervention rates using multivariable logistic regression.

Main Results:

  • 72% of 16,263 firearm injuries required surgery; 36% needed critical care interventions (intubation, tube thoracostomy, blood transfusion).
  • Children (0-13) had the highest rate of central nervous system (CNS) surgical procedures (8%).
  • Children were more likely than adults to undergo CNS procedures (OR 2.24) and receive blood transfusions (OR 1.44), adjusted for covariates.

Conclusions:

  • Firearm injuries pose a high risk for surgical and critical care interventions across all ages.
  • Children with firearm injuries have a significantly higher likelihood of requiring CNS surgical procedures compared to adults.
  • Hospitals must be prepared for immediate stabilization, including advanced interventions, for all firearm injury victims, with a focus on pediatric neurosurgical needs.