A Descriptive Study Evaluating Trends in Firearm Injuries at an Urban, Level 1 Pediatric Trauma Center

In the United States, firearm-related injuries are the leading cause of death in individuals aged 0 to 24 years and lead to substantial cost burden, mortality, and morbidity. This study identifies trends of pediatric firearm injury at this level I pediatric trauma center, which may inform violence prevention and firearm safety intervention at the local level.

This study is a retrospective review of the pediatric trauma registry at a level 1 pediatric trauma center of children (0 to 17.9 y) who presented between January 1, 2013 and December 31, 2022. Age, sex, race, ethnicity, number of GSWs, location of injury, disposition, intention, mortality, insurance status, length of stay, zip code of residence, location of shooting, hospital charges, and recidivism for firearm injury, police officer-related interactions, or violence-related events were reviewed and analyzed.

There were 585 patient charts reviewed over the 10-year period. The rate of pediatric firearm injuries increased by almost 5 folds and fatality rates tripled from 2013 to 2022. The victims were predominantly male (82.9%), black (75.3), non-Hispanic (88.5%), and Medicaid holder/uninsured (86.3%). Assault accounted for 67% of all GSWs and 13.5% returned with an assault or violence-related concern; 6.4% returned for a GSW-related injury over the study period. The rate of firearm injuries increased from 9.09 (per 100,000) pre-COVID to 17.93 (per 100,000) post-COVID with a rate of 16.74 (per 100,000) while in the peak of the pandemic.

This level 1 trauma center has seen an overall increase in pediatric GSW injuries and fatalities in 10 years.