Citation

Tashiro J, Lane RS, Blass LW, Perez EA, Sola JE. J. Trauma Acute Care Surg. 2016; 81(4 Suppl 1 Forging New Frontiers: The 20th Annual Conference of the Injury Free): S54-S60.

Affiliation

Division of Pediatric Surgery, DeWitt-Daughtry Department of Surgery, University of Miami Miller School of Medicine, Miami, FL.

Copyright

(Copyright © 2016, Lippincott Williams and Wilkins)

DOI

10.1097/TA.0000000000001177

PMID

27488481

Abstract

BACKGROUND: Gun control laws vary greatly between states within the United States. We hypothesized that states with strict gun laws have lower mortality and resource utilization rates from pediatric firearm-related injury admissions.

METHODS: Kids' Inpatient Database (1997-2012) was searched for accidental (E922), self-inflicted (E955), assault (E965), legal intervention-related (E970), or undetermined circumstance (E985) firearm injuries. Patients were <20 years of age and admitted for their injuries. Case incidence trends were examined for the study period. Propensity score (PS)-matched analyses were performed using 38 covariates to compare outcomes between states with strict or lenient gun control laws.

RESULTS: Overall, 38424 cases were identified, with an overall mortality of 7%. Firearm injuries were most commonly assault (64%), followed by accidental (25%), undetermined circumstance (7%), or self-inflicted (3%). A small minority involved military-grade weapons (0.2%). Most cases occurred in lenient gun control states (48%), followed by strict (47%), and neutral (6%).On 1:1 PS-matched analysis, in-hospital mortality by case was higher in lenient (7.5%) vs. strict (6.5%) states, p=0.013. Lenient states had a proportionally higher rate of accidental (31%) and self-inflicted injury (4%) vs. strict states (17% and 1.6%, respectively), p<0.001. Assault-related injuries were proportionally lower in lenient (54%) vs. strict (75%) states, p<0.001. Military-grade weapons were more common in lenient (0.4%) vs. strict (0.1%) states, p=0.001.

CONCLUSIONS: These findings highlight the importance of legislative measures and their role in injury prevention, as firearm injuries are entirely avoidable mechanisms of injury. Lenient gun control not only contributes to worse outcomes per case, but also to a more significant and detrimental impact on public health. LEVEL OF EVIDENCE: III, Prognostic and Epidemiological.

Language: en