Byron D Hughes1, Claire B Cummins2, Yong Shan3, Hemalkumar B Mehta4, Ravi S Radhakrishnan5, Kanika A Bowen-Jallow6. 1. Department of Surgery, University of Texas Medical Branch, 301 University Blvd., Galveston, TX, 77555, USA. Electronic address: bdhughes@utmb.edu. 2. Department of Surgery, University of Texas Medical Branch, 301 University Blvd., Galveston, TX, 77555, USA. Electronic address: cbcummins@utmb.edu. 3. Department of Surgery, University of Texas Medical Branch, 301 University Blvd., Galveston, TX, 77555, USA. Electronic address: yoshan@utmb.edu. 4. Department of Surgery, University of Texas Medical Branch, 301 University Blvd., Galveston, TX, 77555, USA. Electronic address: hbmehta@utmb.edu. 5. Division of Pediatric Surgery, University of Texas Medical Branch, 301 University Blvd., Galveston, TX, 77555, USA. Electronic address: rsradhak@utmb.edu. 6. Division of Pediatric Surgery, University of Texas Medical Branch, 301 University Blvd., Galveston, TX, 77555, USA. Electronic address: kabowen@utmb.edu.
Abstract
BACKGROUND/ PURPOSE: The U.S. has an alarming rate of firearm injuries. Racial disparities among victims and predictors of outcomes are not well established. Our objective was to assess costs, length of stay (LOS), and inpatient mortality among nonfatal and fatal pediatric firearm injuries that required hospitalization. METHODS: Pediatric (≤18 years of age) hospitalizations with a firearm injury discharge diagnosis were identified from the national Kids' Inpatient Databases (KID) for 2006 through 2012. Firearm injury intent, weapon type, and hospitalization rates by racial groups were examined. Inpatient mortality, costs, and length of stay were examined using regression models. RESULTS: Of 15,211 hospitalizations, the majority of injuries were due to assault (60%) and the intentions of firearm injury differed by race (p < 0.001). The median cost per hospitalization was $10,159 (interquartile range: $5071 to $20,565), totaling more than a quarter of a billion dollars. On regression analysis, Black (OR: 0.41; CI: 0.30-0.55) and Hispanic (OR: 0.47; CI: 0.34-0.66) patients were less likely to die than White patients. CONCLUSION: Pediatric firearm injury circumstances and survival vary by race with Whites being more likely to experience unintentional injury and suicide, while Blacks and Hispanics are more likely to experience inflicted injury. LEVEL OF EVIDENCE: Level II. TYPE OF STUDY: Clinical Research Study.
BACKGROUND/ PURPOSE: The U.S. has an alarming rate of firearm injuries. Racial disparities among victims and predictors of outcomes are not well established. Our objective was to assess costs, length of stay (LOS), and inpatient mortality among nonfatal and fatal pediatric firearm injuries that required hospitalization. METHODS: Pediatric (≤18 years of age) hospitalizations with a firearm injury discharge diagnosis were identified from the national Kids' Inpatient Databases (KID) for 2006 through 2012. Firearm injury intent, weapon type, and hospitalization rates by racial groups were examined. Inpatient mortality, costs, and length of stay were examined using regression models. RESULTS: Of 15,211 hospitalizations, the majority of injuries were due to assault (60%) and the intentions of firearm injury differed by race (p < 0.001). The median cost per hospitalization was $10,159 (interquartile range: $5071 to $20,565), totaling more than a quarter of a billion dollars. On regression analysis, Black (OR: 0.41; CI: 0.30-0.55) and Hispanic (OR: 0.47; CI: 0.34-0.66) patients were less likely to die than White patients. CONCLUSION: Pediatric firearm injury circumstances and survival vary by race with Whites being more likely to experience unintentional injury and suicide, while Blacks and Hispanics are more likely to experience inflicted injury. LEVEL OF EVIDENCE: Level II. TYPE OF STUDY: Clinical Research Study.
Authors: Emma C Hamilton; Charles C Miller; Charles S Cox; Kevin P Lally; Mary T Austin Journal: J Trauma Acute Care Surg Date: 2018-04 Impact factor: 3.313
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