ORLANDO – The majority of children and adolescents who presented with firearm-related injuries to an urban level 1 trauma center over a 6-year period were black males over age 14 years according to a retrospective review of patient records.
Furthermore, children aged 14 years and younger were more likely than were older children to be shot at home, Dr. Andrea C. Suen reported at the annual meeting of the American Academy of Pediatrics.
The findings, which also characterized other age-related injury patterns, injury sites, and methods of transportation to the hospital, provide important information that could help in the development of effective crime- and injury-prevention strategies, she said.
Of 456 patients aged 18 years and younger who presented to the trauma center between January 2005 and 2010, 78 were aged 14 years or younger and 378 were aged 15-18 years. Overall, 86% were male, and 80% were black, but these figures differed by age group; 72% and 89% of those 14 years and younger and those 15-18 years, respectively, were male, and 64% and 83% of those 14 years and younger and those 15-18 years, respectively, were black, said Dr. Suen, a third-year pediatric emergency medicine fellow at the University of Florida Health Science Center, Jacksonville.
Those aged 14 years and younger were almost four times more likely to be shot at home (odds ratio, 3.76), and were much more likely to arrive by ambulance than by private car or to walk in than those aged 15-18 years.
The most common injury sites among children under age 14 years were the extremities (51% of cases), the trunk (41%), the head (16%), and the neck (9%). Those aged 5-9 years had a greater than sixfold increase in the likelihood of multiple injury sites, compared with those aged 10-14 years (OR, 6.26), she said.
In both age groups, 7.1% of patients died as a result of their injury.
In nearly 70% of cases, the shooter was someone unknown to the patient, and in 64% of cases, the type of firearm was unknown.
The findings of this study illustrate important age-based differences in firearm injuries, and highlight a need for improved reporting in firearm-related incidents, according to primary author and investigator, Dr. Phyllis Hendry of the department of emergency medicine at the university, who noted that hospital and emergency medical services reports in this study often lacked important details – such as patient’s relationship to the shooter and type of gun used – necessary for development of effective prevention strategies.
In an interview, Dr. Hendry further noted that the findings underscore the need for pediatricians to address gun safety and precautions in the home, as firearm-related injuries in children and adolescents are an important cause of preventable injury and mortality.
Also, emergency physicians should consider making a referral to child protective services on pediatric firearm injuries to assess the safety of the home, she said. "In our study, only 13% of patients 0-14 years of age had child-protection referrals documented."
Dr. Suen and Dr. Hendry reported having no disclosures.