Substance use and mental health disorders in pediatric firearm trauma

Firearm injuries are prevalent among children in the United States and induce significant psychological distress. This study aims to identify clinical predictors for developing mental health disorders (MHD) and substance use disorders (SUD) after firearm injury within the pediatric population.

The National Readmissions Database was queried from 2016 to 2022 for patients ≤18 years old with hospital admissions for firearm injuries. The primary outcome was the presence of new MHD or SUD during hospital readmissions. Multivariable regression analysis was used to test the independent association of medical and surgical complications with MHD and SUD while controlling for confounders, including the presence of MHD and SUD at index admission.

There were 35,733 hospital admissions, with a mortality rate of 6.4 %. Survivors were mostly male (86 %), with a median age of 17 years [IQR 15, 18]. Patients were most commonly from the lowest income quartile (57 %). Baseline MHDs or SUDs were present in 20 % of the population, and these patients suffered worse injuries and more complicated hospital courses. New MHDs or SUDs occurred in 2.2 % of the population. Females, those with self-inflicted injuries, those who underwent surgical procedures, and those with medical/surgical complications are at increased risk of developing new MHDs or SUDs. Within the same calendar year, 11 % of patients were readmitted, and 33 % of patients requiring readmission presented to a different hospital.

MHD and SUD are prevalent after pediatric firearm injuries in the United States. Children with complicated hospital courses after firearm injury may benefit from early mental health screening and intervention.

IV.

Retrospective cohort analysis.