Pediatric Firearm Injury Trends in the United States: A National Trauma Data Bank (NTDB) Analysis
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In brief
In brief
National Trauma Data Bank analysis of 20,083 pediatric firearm injuries (2013-2017) reveals adolescent males and African Americans are disproportionately affected, with 71% of incidents being assaults. Racial disparities are stark: African Americans comprise 70% of assault victims while Caucasians represent 70% of suicides, highlighting urgent need for targeted prevention strategies.
Written by the GCMD Library team from the article.
Aim of Study
Firearm injuries are the second leading cause of injury-related death in the USA in children under 18. We compared overall and intent-specific firearm hospitalizations across age group and race to understand recent trends.
Methods
A retrospective cohort of 20,083 children from the National Trauma Data Bank involved in incidences of firearm discharges from 2013-2017 was divided by race, discharge intent, gun type, and four age groups: infants (ages 0-2), toddlers (3-6), children (7-12), and adolescents (13-18). Discharge intent and gun type were determined by ICD-9-CM and ICD-10-CM External Causes of Injury codes. Injury severity score (ISS), hospital discharge disposition, and length of stay (LOS) were used as predictors for morbidity and mortality.
Results
From 2013 to 2017, there were on an average 4016 firearm injuries reported to the NTDB (n=20,083). 71% (n=14313) of the incidents were assaults. Victims who identified as African American and Caucasian made up 60% (n=11890) and 26% (n=5162) of the total victims, respectively, and were predominantly male (86%, n=17202). Victims who identified as Caucasian made up 70% of suicides (n=819), while African Americans made up 70% of assaults (n=9733). 87% (n=17525) of the patient population were adolescents. The number of accidental firearm discharges compared to firearm assaults was greater for toddlers, while the opposite was true for infants, children, and adolescents. Average LOS by age group varied each year, though children had the highest total average LOS. Average ISS was highest for infants and adolescents (11.5 and 10.4) and American Indians and Caucasians (10.1 and 11.1). Overall mortality rate was 6% (n=1220) and had no significant differences between years. Mortality rate was highest for infants (7%, n=25).
Conclusions
Adolescent males and African Americans were disproportionately affected by overall and assault-specific firearm discharges. Firearm injury prevention legislation is critical to prevent these injures.