title: Racial/Ethnic Specific Trends in Pediatric Firearm-Related Hospitalizations in the United States, 1998-2011.
abstract: OBJECTIVE
  To determine the temporal patterns and the difference in trends by race/ethnicity of pediatric firearm hospitalizations (FH) among those aged 15 years or younger in the United States.
  
  
  METHODS
  Data on pediatric FH was retrieved from the Nationwide Inpatient Sample between 1998 and 2011 (n = 16,998,470) using external cause of injury codes (E-codes) of the International Classification of Diseases, Ninth Revision, Clinical modification, (assault: E9650-E9654, unintentional: E9220-E9224, E9228, and E9229, suicide: E9550-E9554, E9556, and E9559, undetermined: E9850-E9854, and E9856 and legal: E970). Meta-regression was used to determine the significance of temporal trends. Survey logistic regression adjusted for survey year was used to examine association of pediatric FH with social and demographic characteristics.
  
  
  RESULTS
  An annual reduction of 1.07 per 100,000 hospitalizations (p-trend = 0.011) was observed between 1998 and 2011. There was reduction in rate of unintentional-FH (p-trend = 0.013), suicide-FH (p-trend = 0.029), and undetermined-FH (p-trend = 0.002), but not assault-FH (p-trend = 0.18). A decline in rates of FH was observed among whites (p-trend = 0.021) and Hispanics (p-trend = 0.03) while an increase in rates of assault-FH was observed among black children. All other intents and all other racial/ethnic groups showed declining rates during this interval.
  
  
  CONCLUSIONS
  There was an overall decline in rates of pediatric FHs in this time period driven by a decline in unintentional-FHs. However there was an increase in assault FH among black children during this same time period.
authors.affiliation: Center for Clinical Translational Epidemiology and Comparative Effectiveness Research, Department of Medicine, Boston University School of Medicine, 801 Massachusetts Ave, Suite 470, Boston, MA, 02118, USA. kalesan@bu.edu.|Gun Violence Survivors Foundation, Philadelphia, PA, USA. kalesan@bu.edu.|Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA. kalesan@bu.edu.
authors.forename: Bindu
authors.initials: B
authors.lastname: Kalesan
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA.
authors.forename: Stefan
authors.initials: S
authors.lastname: Dabic
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA.
authors.forename: Sowmya
authors.initials: S
authors.lastname: Vasan
authors.affiliation: Department of Surgery, Columbia University Medical Center, New York, NY, 10032, USA.
authors.forename: Steven
authors.initials: S
authors.lastname: Stylianos
authors.affiliation: Boston University School of Public Health, Boston, MA, 02118, USA.
authors.forename: Sandro
authors.initials: S
authors.lastname: Galea
mesh_terms: D000293:Adolescent; D001741:Black or African American / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D005389:Firearms; D006306:Health Surveys; D006760:Hospitalization / Q000706:statistics & numerical data* / Q000639:trends*; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D011204:Poverty Areas; D044469:Racial Groups; D012307:Risk Factors; D013405:Suicide / Q000208:ethnology / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data; D014948:Wounds, Gunshot / Q000208:ethnology* / Q000209:etiology
keywords: Firearm injury; Hospitalization; Injury severity; Pediatric; Temporal trends