Citation

Kwon EG, Wang BK, Iverson KR, O'Connell KM, Nehra D, Rice-Townsend SE. J. Pediatr. Surg. 2022; ePub(ePub): ePub.

Copyright

(Copyright © 2022, Elsevier Publishing)

DOI

10.1016/j.jpedsurg.2022.09.009

PMID

unavailable

Abstract

PURPOSE
We aim to describe interpersonal violence-related injury patterns in the pediatric trauma population and to identify predictors of recidivism.
Methods
In this retrospective analysis from a single institution, we included pediatric patients (≤17 years) treated (2006-2020) for traumatic injury related to interpersonal violence (IPV). Patient characteristics were compared among mechanism types and between recidivists and non-recidivists using two sample t-tests, Wilcoxon rank-sum tests, and Pearson's chi-squared. Multivariate analysis was performed using logistic regression to identify predictors of repeat injury.
Results
We identified 635 pediatric patients who sustained injuries due to IPV: firearm (N=266), assault (stab/blunt; N=243), and abuse (N=126). The average age of the firearm, assault, and abuse groups was 15.5, 14.7, and 1.1 years (SD=2.2, 3.4, 2.4 years), respectively. Majority of the overall cohort was male (77.5%) and publicly- or un-insured (67.8%), with 28.0% being Black. Of the 489 firearm and assault patients who survived the first injury, 30 (6.1%) had repeat injury due to IPV requiring treatment at our center with a median time of 40 months (IQR 17-62 months) between first and second injury. The majority of recidivists (83.3%) were victims of gun violence whereas the distribution between assault and firearm in the non-recidivists was more even at 51 and 49%, respectively (p<0.001). Eighteen (60.0%) of the recidivist patients had the same mechanism between the first and second injury. In the logistic regression analysis, Black race and firearm injury were associated with greater than 3-fold higher likelihood of repeat injury compared to white race after adjusting for age, sex, insurance, and child opportunity index.
Conclusions
We found that survivors of firearm injuries and assault comprise a vulnerable patient cohort at risk for repeat injury, and Black race is an independent predictor of repeat injury due to IPV. These findings provide guidance for developing violence prevention programs.
Type of Study
Retrospective Comparative Study
Level of Evidence
Level III

Language: en

Keywords

Social determinants of health; Recidivism; Firearm; nterpersonal violence