背景:枪支相关伤害是一种公共卫生危机,仍然是1至15岁年龄第三大最常见的死亡原因。通过评估围绕此类伤害的事件,基于证据的干预策略的努力可能有针对性,以最大限度地提高影响。
方法:在2016年1月至2020年12月期间,在城市儿科1级创伤中心对15岁及以下患者的枪支相关伤害进行了回顾性图表回顾。年龄,性别,种族/民族,损伤严重程度评分(ISS),报告的受伤原因,学校和宵禁周围受伤的时间,和死亡率进行了评估。体检医师的数据确定了发生在医院集水区的其他死亡。
结果:共有195人受伤,其中14人来自体检医师。总的来说,82.6%为男性,中位年龄为14岁(范围1-15;IQR13-15),中位数为5(IQR1-10)。非裔美国儿童占队列的74.9%,而仅占当地学校的35.9%。故意人际伤害占65.6%;17.4%是旁观者;7.2%是疏忽放电;和0.5%自杀。故意人际伤害的中位年龄为14岁(IQR13-15),而疏忽放电的中位年龄为11岁(IQR8-14,P=0.03)。关于时机,6.9%的伤害发生在上课时间;放学后或非上课时间占56.4%;合法宵禁后占36.7%。死亡率为17.4%。
结论:枪支安全教育和社区暴力干预应在青少年前开始。与儿童枪支有关的伤害预防战略必须多方面解决结构性种族主义,逃学,违反宵禁,课外活动,儿童保育选择,枪械安全教育,减少暴力,自杀预防,和累犯。
BACKGROUND: Firearm-related injury is a public health crisis and remains the 3rd most common cause of death from ages 1 15 years. By evaluating events surrounding such injuries, evidence-based intervention strategies efforts may be targeted to maximize impact.
METHODS: A retrospective chart review was performed for firearm-related injuries in patients 15 years-old and under at an urban Pediatric Level 1 Trauma Center between January 2016 and December 2020. Age, gender, race/ethnicity, injury severity score (ISS), reported cause of injury, timing of injury around school and curfew, and mortality were evaluated. Medical Examiner data identified other deaths that occurred within the hospital\'s catchment area.
RESULTS: There were 195 injuries including 14 from the Medical Examiner. Overall, 82.6% were male with median age of 14 years (range 1-15; IQR 13-15), and median ISS of 5 (IQR 1-10). African-American children comprised 74.9% of the cohort while only representing 35.9% of local schools. Intentional interpersonal injuries comprised 65.6%; 17.4% were bystanders; 7.2% were negligent discharges; and 0.5% suicide. Median age for intentional interpersonal injuries was 14 years (IQR 13-15) compared to 11 years (IQR 8-14, P = 0.03) for negligent discharges. Regarding timing, 6.9% of injuries occurred during school hours; 56.4% after school or during non-school days; and 36.7% were after legal curfew. Mortality rate was 17.4%.
CONCLUSIONS: Firearm safety education and community-based violence intervention should start in the pre-teen years. Pediatric firearm-related injury prevention strategies must be multifaceted addressing structural racism, truancy, curfew violation, extra-curricular activities, childcare options, firearm safety education, violence reduction, suicide prevention, and recidivism.