Eva M Urrechaga1, Justin Stoler2, Kirby Quinn3, Alessia C Cioci1, Veronica Nunez3, Yvette Rodriguez3, Hallie J Quiroz1, Matthew S Sussman1, Eduardo A Perez1, Henri R Ford4, Juan E Sola1, Chad M Thorson5. 1. Dewitt-Daughtry Family Department of Surgery, Divisions of Pediatric Surgery & Trauma and Acute Care Surgery, University of Miami Miller School of Medicine, Miami, FL, USA. 2. Department of Geography, University of Miami, Coral Gables, FL, USA; Department of Public Health Sciences, Miller School of Medicine, Miami, FL, USA. 3. University of Miami Miller School of Medicine, Miami, FL, USA. 4. Dewitt-Daughtry Family Department of Surgery, Divisions of Pediatric Surgery & Trauma and Acute Care Surgery, University of Miami Miller School of Medicine, Miami, FL, USA; University of Miami Miller School of Medicine, Miami, FL, USA. 5. Dewitt-Daughtry Family Department of Surgery, Divisions of Pediatric Surgery & Trauma and Acute Care Surgery, University of Miami Miller School of Medicine, Miami, FL, USA. Electronic address: cthorson@med.miami.edu.
Abstract
PURPOSE: Firearm injuries (GSW) are a growing public health concern and leading cause of morbidity and mortality among children, yet predictors of injury remain understudied. This study examines the correlates of pediatric GSW within our county. METHODS: We retrospectively queried an urban Level 1 trauma center registry for pediatric (0-18 years) GSW from September 2013 to January 2019, examining demographic, clinical, and injury information. We used a geographic information system to map GSW rates and perform spatial and spatiotemporal cluster analysis to identify zip code "hot spots." RESULTS: 393 cases were identified. The cohort was 877% male, 87% African American, 10% Hispanic, and 22% Caucasian/Other. Injuries were 92% violence-related and 4% accidental, with 63% occurring outside school hours. Mortality was 12%, with 53% of deaths occurring in the resuscitation unit. Zip-level GSW rates ranged from 0 to 9 (per 1000 < 18 years) by incident address and 0-6 by home address. Statistically significant hot spots were in predominantly underserved African American and Hispanic neighborhoods. CONCLUSIONS: Geodemographic analysis of pediatric GSW injuries can be utilized to identify at-risk neighborhoods. This methodology is applicable to other metropolitan areas where targeted interventions can reduce the burden of gun violence among children. TYPE OF STUDY: Retrospective study. LEVEL OF EVIDENCE: Level III.
PURPOSE: Firearm injuries (GSW) are a growing public health concern and leading cause of morbidity and mortality among children, yet predictors of injury remain understudied. This study examines the correlates of pediatric GSW within our county. METHODS: We retrospectively queried an urban Level 1 trauma center registry for pediatric (0-18 years) GSW from September 2013 to January 2019, examining demographic, clinical, and injury information. We used a geographic information system to map GSW rates and perform spatial and spatiotemporal cluster analysis to identify zip code "hot spots." RESULTS: 393 cases were identified. The cohort was 877% male, 87% African American, 10% Hispanic, and 22% Caucasian/Other. Injuries were 92% violence-related and 4% accidental, with 63% occurring outside school hours. Mortality was 12%, with 53% of deaths occurring in the resuscitation unit. Zip-level GSW rates ranged from 0 to 9 (per 1000 < 18 years) by incident address and 0-6 by home address. Statistically significant hot spots were in predominantly underserved African American and Hispanic neighborhoods. CONCLUSIONS: Geodemographic analysis of pediatric GSW injuries can be utilized to identify at-risk neighborhoods. This methodology is applicable to other metropolitan areas where targeted interventions can reduce the burden of gun violence among children. TYPE OF STUDY: Retrospective study. LEVEL OF EVIDENCE: Level III.