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Indicators of potential disability among pediatric firearm injury survivors
Lauren T Callaghan-Raab1, Aden C Feustel2, Caitlin T Perez-Stable1
1School of Medicine, Baylor College of Medicine, 1 Baylor Plz, Houston, TX 77030, USA.
Insights
Nearly one-third of pediatric firearm injury survivors face long-term symptoms. Higher injury severity and intensive care unit admission predict these persistent issues, emphasizing the need for ongoing care.
Area of Science:
- Trauma Surgery
- Pediatric Medicine
- Public Health
Background:
- Pediatric firearm injury is a critical national issue with survivors often experiencing long-term disabilities.
- While many injuries are fatal, a significant proportion of children survive, necessitating research into their outcomes.
- Understanding the long-term consequences is vital for improving care for young firearm injury survivors.
Purpose of the Study:
- To characterize the outcomes of pediatric firearm injuries.
- To identify predictors associated with persisting symptoms in pediatric firearm injury survivors.
- To inform strategies for mitigating long-term disability in this population.
Main Methods:
- A retrospective cohort study was conducted involving pediatric patients (0-17 years) treated for firearm injuries.
- Data were gathered from trauma registries, medical charts, and public records across three Level I trauma centers.
- Multivariable logistic regression analyzed predictors of persisting symptoms, defined as those present 3+ months post-discharge.
Main Results:
- Among 287 survivors with follow-up data, 83 (28.9%) experienced persisting physical or mental health symptoms.
- Impaired mobility was the most common persistent symptom, affecting 47% of those with sequelae.
- Higher New Injury Severity Score, intensive care unit admission, and extremity injuries predicted increased odds of persisting symptoms.
Conclusions:
- Nearly one-third of pediatric firearm injury survivors experience persistent symptoms beyond three months.
- These findings underscore the necessity for long-term follow-up and active screening for physical and psychological sequelae.
- Early referral to rehabilitation and mental health services is crucial for preventing long-term disability.
Background:
Pediatric firearm injury represents an increasing national crisis. While many injuries are fatal, a greater proportion of children survive, often facing significant long-term disabilities. This study aims to characterize the outcomes of pediatric firearm injury and identify predictors of persisting symptoms.
Methods:
We conducted a retrospective cohort study of patients aged 0-17 years treated for firearm injuries at three Level I trauma centers in a major U.S. city from 2018 to 2020. Data was collected from trauma registries, medical charts, and public records, including demographics, details regarding shooting context, injury data, clinical management, and outcomes. Persisting symptoms were defined as symptoms related to the injury documented at 3 or more months after hospital discharge. Multivariable logistic regression analyses were used to identify predictors of persisting symptoms.
Results:
Of 360 pediatric survivors, 287 (79.7 %) had follow-up data available. Among them, 83 (28.9 %) experienced persisting physical or mental health symptoms, with impaired mobility being the most common symptom affecting 39 patients (47 %). Adjusted analyses demonstrated that higher New Injury Severity Score, intensive care unit admission, and extremity injuries were significantly associated with increased odds of persisting symptoms. Age, gender, race/ethnicity, and shooting context were not statistically significant predictors. Seventy-three patients (20.3 %) were lost to follow-up and were a marginally older sub-population.
Conclusions:
Nearly one-third of pediatric firearm injury survivors experience persisting symptoms beyond 3 months post-injury. These data highlight the need for long-term follow-up, active screening for physical and psychological sequelae, and early referral to rehabilitation and mental health services to help prevent long-term disability.
