Joe W Brewer1, Charles S Cox2, Stephen A Fletcher1, Manish N Shah1, Michelle Sandberg3, David I Sandberg4. 1. Division of Pediatric Neurosurgery, Departments of Pediatric Surgery and Neurosurgery, McGovern Medical School/University of Texas Health Science Center at Houston and Mischer Neuroscience Institute, Houston, Texas, USA. 2. Department of Pediatric Surgery, McGovern Medical School/University of Texas Health Science Center at Houston, Houston, Texas, USA. 3. Department of Pediatrics, Santa Clara Valley Medical Center and Stanford University School of Medicine, Palo Alto, California, USA. 4. Division of Pediatric Neurosurgery, Departments of Pediatric Surgery and Neurosurgery, McGovern Medical School/University of Texas Health Science Center at Houston and Mischer Neuroscience Institute, Houston, Texas, USA. Electronic address: David.I.Sandberg@uth.tmc.edu.
Abstract
BACKGROUND: This study sought to determine the role of social factors in pediatric gunshot wounds (GSW). METHODS: We identified medical records of victims aged 0-15 years who presented to our Level 1 pediatric trauma center from 2001 to 2016. RESULTS: Three hundred fifty-eight children were treated between 2001 and 2016. Patients ranged from 2.5 months to 15 years old (mean = 10.8 years). Two hundred ninety-two patients (81.6%) were male, and 66 (18.4%) were female. The most common anatomic injury location was the head, face, neck, and/or spine (n = 168; 36.2%). 38.3% of injuries (n = 137) were caused by handguns, 25.1% (n = 90) by BB guns, and 12.6% (n = 45) by shotguns/rifles. 45.5% of incidents (n = 163) were intentional; 17 of these (4.7%) were suicide attempts. 48.9% of incidents (n = 175) were accidental. The majority (n = 229) of incidents (64.0%) occurred in a family residence. An adult supervised the victim in only 26.3% of cases (N = 94). Criminal charges were filed in 36 cases (10.1%). Fifteen victims (4.2%) were placed in CPS custody. 12.0% of charts (N = 43) mentioned gun safety education being provided to the family. CONCLUSION: Analysis of social factors associated with pediatric GSW suggests that many of these injuries could have been prevented with safe firearm storage, increased community education efforts, and other safety measures. LEVELS OF EVIDENCE: Level III- Retrospective Comparative Study.
BACKGROUND: This study sought to determine the role of social factors in pediatric gunshot wounds (GSW). METHODS: We identified medical records of victims aged 0-15 years who presented to our Level 1 pediatric trauma center from 2001 to 2016. RESULTS: Three hundred fifty-eight children were treated between 2001 and 2016. Patients ranged from 2.5 months to 15 years old (mean = 10.8 years). Two hundred ninety-two patients (81.6%) were male, and 66 (18.4%) were female. The most common anatomic injury location was the head, face, neck, and/or spine (n = 168; 36.2%). 38.3% of injuries (n = 137) were caused by handguns, 25.1% (n = 90) by BB guns, and 12.6% (n = 45) by shotguns/rifles. 45.5% of incidents (n = 163) were intentional; 17 of these (4.7%) were suicide attempts. 48.9% of incidents (n = 175) were accidental. The majority (n = 229) of incidents (64.0%) occurred in a family residence. An adult supervised the victim in only 26.3% of cases (N = 94). Criminal charges were filed in 36 cases (10.1%). Fifteen victims (4.2%) were placed in CPS custody. 12.0% of charts (N = 43) mentioned gun safety education being provided to the family. CONCLUSION: Analysis of social factors associated with pediatric GSW suggests that many of these injuries could have been prevented with safe firearm storage, increased community education efforts, and other safety measures. LEVELS OF EVIDENCE: Level III- Retrospective Comparative Study.
Authors: Hooman Alexander Azad; Michael C Monuteaux; Chris A Rees; Michael Siegel; Rebekah Mannix; Lois K Lee; Karen M Sheehan; Eric W Fleegler Journal: JAMA Pediatr Date: 2020-05-01 Impact factor: 16.193