@article{ref1,
title="When public health crises collide: 5 years of pediatric firearm injury prevention opportunities",
journal="Trauma surgery and acute care open",
year="2023",
author="Tatebe, Leah C. and Cone, Jennifer T. and Slidell, Mark B. and Chang, Grace and Jonikas, Meghan and Stewart, Amy and Doherty, James and Arunkumar, Ponni and Schlanser, Victoria and Dennis, Andrew J.",
volume="8",
number="1",
pages="e001026-e001026",
abstract="OBJECTIVES: Prior publications on pediatric firearm-related injuries have emphasized significant social disparities. The pandemic has heightened a variety of these societal stresses. We sought to evaluate how we must now adapt our injury prevention strategies. <br><br>PATIENTS AND METHODS: Firearm-related injuries in children 15 years old and under at five urban level 1 trauma centers between January 2016 and December 2020 were retrospectively reviewed. Age, gender, race/ethnicity, Injury Severity Score, situation, timing of injury around school/curfew, and mortality were evaluated. Medical examiner data identified additional deaths. <br><br>RESULTS: There were 615 injuries identified including 67 from the medical examiner. Overall, 80.2% were male with median age of 14 years (range 0-15; IQR 12-15). Black children comprised 77.2% of injured children while only representing 36% of local schools. Community violence (intentional interpersonal or bystander) injuries were 67.2% of the cohort; 7.8% were negligent discharges; and 2.6% suicide. Median age for intentional interpersonal injuries was 14 years (IQR 14-15) compared with 12 years (IQR 6-14, p<0.001) for negligent discharges. Far more injuries were seen in the summer after the stay-at-home order (p<0.001). Community violence and negligent discharges increased in 2020 (p=0.004 and p=0.04, respectively). Annual suicides also increased linearly (p=0.006). 5.5% of injuries were during school; 56.7% after school or during non-school days; and 34.3% were after legal curfew. Mortality rate was 21.3%. <br><br>CONCLUSIONS: Pediatric firearm-related injuries have increased during the past 5 years. Prevention strategies have not been effective during this time interval. Prevention opportunities were identified specifically in the preteenage years to address interpersonal de-escalation training, safe handling/storage, and suicide mitigation. Efforts directed at those most vulnerable need to be reconsidered and examined for their utility and effectiveness. LEVEL OF EVIDENCE: Level III; epidemiological study type.<p /> <p>Language: en</p>",
language="en",
issn="2397-5776",
doi="10.1136/tsaco-2022-001026",
url="http://dx.doi.org/10.1136/tsaco-2022-001026"
}