title: An analysis of pediatric gunshot wounds treated at a Level I pediatric trauma center.
abstract: BACKGROUND
  We reviewed the incidence and injury severity of children with gunshot wounds (GSWs) at our hospital.
  
  
  METHODS
  We compared trauma registry, emergency unit (EU), and admissions data from January 1993 to June 1996 (period I) and July 1996 to December 1999 (period II). Outcome measures included EU disposition (death, immediate operation, pediatric intensive care unit, ward), injury severity, mortality, and injury cause (accidental, intentional).
  
  
  RESULTS
  We treated 437 children for GSWs in the EU, with 238 (54%) admissions and 199 discharges. Comparing period I versus period II, patients treated declined from 288 to 149 (-52%, p < 0.001), and admissions decreased from 159 to 79 (-50%, p < 0.001). Injury severity increased from 35% to 57% (p < 0.001). Patients requiring immediate operations increased from 20% to 42% (p < 0.001). Direct ward admissions declined from 65% to 43% (p < 0.001). Deaths occurred in 3% of patients in both time periods. Accidental and intentional GSWs were evenly divided.
  
  
  CONCLUSIONS
  An alarming number of children, an average of 62 children annually, were treated for GSWs at our hospital. Despite a 52% reduction in GSWs, the percentage of severely injured patients increased by 63%. These data emphasize the importance of prevention, education, early assessment, and operative treatment.
authors.affiliation: Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA.
authors.forename: Alison K
authors.initials: AK
authors.lastname: Snyder
authors.forename: Li Ern
authors.initials: LE
authors.lastname: Chen
authors.forename: Robert P
authors.initials: RP
authors.lastname: Foglia
authors.forename: Patrick A
authors.initials: PA
authors.lastname: Dillon
authors.forename: Robert K
authors.initials: RK
authors.lastname: Minkes
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007223:Infant; D015601:Injury Severity Score; D008297:Male; D008923:Missouri / Q000453:epidemiology; D010043:Outcome and Process Assessment, Health Care; D012189:Retrospective Studies; D017678:Sex Distribution; D015996:Survival Rate; D014193:Trauma Centers / Q000706:statistics & numerical data*; D014948:Wounds, Gunshot / Q000145:classification / Q000453:epidemiology* / Q000628:therapy*