Firearm-Related Pediatric Head Trauma: A Scoping Review

Abstract

BACKGROUND: Firearm-related injury is a significant cause of morbidity and mortality in pediatric populations. Despite a disproportionate role in the most morbid outcomes in both traumatic brain injury and firearm-related injury populations, firearm-related traumatic brain injury (frTBI) is an understudied epidemiological entity. There is need to increase understanding and promote interventions that reduce this burden of disease. OBJECTIVE: To assess the evidence characterizing pediatric frTBI to highlight trends and gaps regarding burden of disease and interventions to reduce frTBI. METHODS: We conducted a scoping review under Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Scoping Review (PRISMA-ScR) guidelines on peer-reviewed studies across 5 databases (Medline OVID, EMBASE, Web of Science Legal Collection, Psy-chINFO, and Academic Search Complete). English studies examining pediatric frTBI epidemiology, prevention, and/or social or legal policy advocacy were included. Articles were excluded if they more generally discussed pediatric firearm-related injury without specific analysis of frTBI. RESULTS: Six studies satisfied inclusion criteria after screening and full-text assessment. Limited studies specifically addressed the burden of disease caused by frTBI. There was an increased risk for both injury and death from frTBI in men, preteenage and teenage youths, minorities, and individuals in firearm-owning households. Further study is required to ascertain if suggested methods of targeted patient screening, firearm-injury prevention counseling, and advocacy of safety-oriented policy tangibly affect rates or outcomes of pediatric frTBI. CONCLUSION: By understanding published epidemiological data and areas of intervention shown to reduce frTBIs, neurosurgeons can become further engaged in public health and prevention rather than strictly treatment after injury.

Firearm-Related Traumatic Brain Injuries in Adults: A Scoping Review

“…Efforts to reduce firearm-related TBI in the United States focus on policy reform and gun access regulation, as studies demonstrate their impact on reducing homicides, nonfatal shootings, and gang-related incidents. 55 Regional distribution highlights the prevalence of firearm injuries in the South and West regions, prompting examination of state-level firearm laws. Extensive literature reports an association between more restrictive state firearm regulations and decreased fatalities, lower household firearm ownership, reduced female firearm deaths, and decreased homicide and suicide rates.…”

“…To ensure methodological rigor, we collaborated with a professional medical librarian who used a method previously used in systematic scoping reviews. 55…”

Commentary: Calcitonin Gene Related Peptide and Its Clinical Utility for the Treatment of Traumatic Brain Injury, Subarachnoid Hemorrhage and Associated Migraine

“…From 2019-2020 alone the rate of firearm violence in the US increased from 4.6 to 6.1 per 100,000 persons [30]. Firearm TBIs are also affecting children and younger adults at a rate exceeding older Americans causing an increase in TBI in younger age cohorts [31]. TBI induced by falls has also been increasing in recent years.…”