Gunshot injuries in children served by emergency services

Craig D. Newgard, Nathan Kuppermann, James F Holmes Jr, Jason S. Haukoos, Brian Wetzel, Renee Y. Hsia, N. Ewen Wang, Eileen M. Bulger, Kristan Staudenmayer, N. Clay Mann, Erik D. Barton, Garen J Wintemute

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

OBJECTIVE: To describe the incidence, injury severity, resource use, mortality, and costs for children with gunshot injuries, compared with other injury mechanisms. METHODS: This was a population-based, retrospective cohort study (January 1, 2006-December 31, 2008) including all injured children age #19 years with a 9-1-1 response from 47 emergency medical services agencies transporting to 93 hospitals in 5 regions of the western United States. Outcomes included population-adjusted incidence, injury severity score $16, major surgery, blood transfusion, mortality, and average per-patient acute care costs. RESULTS: A total of 49 983 injured children had a 9-1-1 emergency medical services response, including 505 (1.0%) with gunshot injuries (83.2% age 15-19 years, 84.5% male). The population-adjusted annual incidence of gunshot injuries was 7.5 cases/100 000 children, which varied 16-fold between regions. Compared with children who had other mechanisms of injury, those injured by gunshot had the highest proportion of serious injuries (23%, 95% confidence interval [CI] 17.6-28.4), major surgery (32%, 95% CI 26.1-38.5), in-hospital mortality (8.0%, 95% CI 4.7-11.4), and costs ($28 510 per patient, 95% CI 22 193-34 827). CONCLUSIONS: Despite being less common than other injury mechanisms, gunshot injuries cause a disproportionate burden of adverse outcomes in children, particularly among older adolescent males. Public health, injury prevention, and health policy solutions are needed to reduce gunshot injuries in children. Pediatrics 2013;132:862-870.

Original languageEnglish (US)
Pages (from-to)862-870
Number of pages9
JournalPediatrics
Volume132
Issue number5
DOIs
StatePublished - Nov 1 2013

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Emergencies
Wounds and Injuries
Confidence Intervals
Emergency Medical Services
Costs and Cost Analysis
Incidence
Emergency
Population
Child Mortality
Injury Severity Score
Health Policy
Hospital Mortality
Blood Transfusion
Patient Care
Cohort Studies
Retrospective Studies
Public Health
Pediatrics
Mortality
Confidence Interval

Keywords

  • Children
  • Health services
  • Trauma
  • Violence

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Arts and Humanities (miscellaneous)

Cite this

Gunshot injuries in children served by emergency services. / Newgard, Craig D.; Kuppermann, Nathan; Holmes Jr, James F; Haukoos, Jason S.; Wetzel, Brian; Hsia, Renee Y.; Wang, N. Ewen; Bulger, Eileen M.; Staudenmayer, Kristan; Mann, N. Clay; Barton, Erik D.; Wintemute, Garen J.

In: Pediatrics, Vol. 132, No. 5, 01.11.2013, p. 862-870.

Research output: Contribution to journalArticle

Newgard, CD, Kuppermann, N, Holmes Jr, JF, Haukoos, JS, Wetzel, B, Hsia, RY, Wang, NE, Bulger, EM, Staudenmayer, K, Mann, NC, Barton, ED & Wintemute, GJ 2013, 'Gunshot injuries in children served by emergency services', Pediatrics, vol. 132, no. 5, pp. 862-870. https://doi.org/10.1542/peds.2013-1350
Newgard, Craig D. ; Kuppermann, Nathan ; Holmes Jr, James F ; Haukoos, Jason S. ; Wetzel, Brian ; Hsia, Renee Y. ; Wang, N. Ewen ; Bulger, Eileen M. ; Staudenmayer, Kristan ; Mann, N. Clay ; Barton, Erik D. ; Wintemute, Garen J. / Gunshot injuries in children served by emergency services. In: Pediatrics. 2013 ; Vol. 132, No. 5. pp. 862-870.
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N2 - OBJECTIVE: To describe the incidence, injury severity, resource use, mortality, and costs for children with gunshot injuries, compared with other injury mechanisms. METHODS: This was a population-based, retrospective cohort study (January 1, 2006-December 31, 2008) including all injured children age #19 years with a 9-1-1 response from 47 emergency medical services agencies transporting to 93 hospitals in 5 regions of the western United States. Outcomes included population-adjusted incidence, injury severity score $16, major surgery, blood transfusion, mortality, and average per-patient acute care costs. RESULTS: A total of 49 983 injured children had a 9-1-1 emergency medical services response, including 505 (1.0%) with gunshot injuries (83.2% age 15-19 years, 84.5% male). The population-adjusted annual incidence of gunshot injuries was 7.5 cases/100 000 children, which varied 16-fold between regions. Compared with children who had other mechanisms of injury, those injured by gunshot had the highest proportion of serious injuries (23%, 95% confidence interval [CI] 17.6-28.4), major surgery (32%, 95% CI 26.1-38.5), in-hospital mortality (8.0%, 95% CI 4.7-11.4), and costs ($28 510 per patient, 95% CI 22 193-34 827). CONCLUSIONS: Despite being less common than other injury mechanisms, gunshot injuries cause a disproportionate burden of adverse outcomes in children, particularly among older adolescent males. Public health, injury prevention, and health policy solutions are needed to reduce gunshot injuries in children. Pediatrics 2013;132:862-870.

AB - OBJECTIVE: To describe the incidence, injury severity, resource use, mortality, and costs for children with gunshot injuries, compared with other injury mechanisms. METHODS: This was a population-based, retrospective cohort study (January 1, 2006-December 31, 2008) including all injured children age #19 years with a 9-1-1 response from 47 emergency medical services agencies transporting to 93 hospitals in 5 regions of the western United States. Outcomes included population-adjusted incidence, injury severity score $16, major surgery, blood transfusion, mortality, and average per-patient acute care costs. RESULTS: A total of 49 983 injured children had a 9-1-1 emergency medical services response, including 505 (1.0%) with gunshot injuries (83.2% age 15-19 years, 84.5% male). The population-adjusted annual incidence of gunshot injuries was 7.5 cases/100 000 children, which varied 16-fold between regions. Compared with children who had other mechanisms of injury, those injured by gunshot had the highest proportion of serious injuries (23%, 95% confidence interval [CI] 17.6-28.4), major surgery (32%, 95% CI 26.1-38.5), in-hospital mortality (8.0%, 95% CI 4.7-11.4), and costs ($28 510 per patient, 95% CI 22 193-34 827). CONCLUSIONS: Despite being less common than other injury mechanisms, gunshot injuries cause a disproportionate burden of adverse outcomes in children, particularly among older adolescent males. Public health, injury prevention, and health policy solutions are needed to reduce gunshot injuries in children. Pediatrics 2013;132:862-870.

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