Firearm injuries in the pediatric population: A tale of one city.
BACKGROUND
Firearm-related injuries are a significant cause of morbidity and mortality in children. To determine current trends and assess avenues for future interventions, we examined the epidemiology and outcome of pediatric firearm injuries managed at our region's two major pediatric trauma centers.


METHODS
Following institutional review board approval, we conducted a 5-year retrospective review of all pediatric firearm victims, 16 years or younger, treated at either of the region's two Level 1 pediatric trauma centers, St. Louis Children's Hospital and Cardinal Glennon Children's Medical Center.


RESULTS
There were 398 children treated during a 5-year period (2008-2013) for firearm-related injuries. Of these children, 314 (78.9%) were black. Overall, there were 20 mortalities (5%). Although most (67.6%) patients were between 14 years and 16 years of age, younger victims had a greater morbidity and mortality. The majority of injuries were categorized as assault/intentional (65%) and occurred between 6:00 pm and midnight, outside the curfew hours enforced by the city. Despite a regional decrease in the overall incidence of firearm injuries during the study period, the rate of accidental victims per year remained stable. Most accidental shootings occurred in the home (74.2%) and were self-inflicted (37.9%) or caused by a person known to the victim (40.4%).


CONCLUSIONS
Despite a relative decrease in intentional firearm-related injuries, a constant rate of accidental shootings suggest an area for further intervention.


METHODS
Prognostic and epidemiologic study, level IV.
From the Division of Pediatric Surgery (P.M.C., M.S.K.), Washington University School of Medicine in Saint Louis; Division of Pediatric Surgery (S.B., C.M.F.), Cardinal Glennon Children's Medical Center; and Department of Emergency Medicine (A.L.), Saint Louis Children's Hospital, Saint Louis, Missouri; Department of General Surgery (C.H.), New York University, New York, New York.
Pamela M
PM
Choi
Charles
C
Hong
Samiksha
S
Bansal
Angela
A
Lumba-Brown
Colleen M
CM
Fitzpatrick
Martin S
MS
Keller
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005389:Firearms; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008923:Missouri / Q000453:epidemiology; D012042:Registries; D012189:Retrospective Studies; D014505:Urban Population; D014948:Wounds, Gunshot / Q000453:epidemiology*