Orthopaedic firearm injuries in children and adolescents: An eight-year experience at a major urban trauma center

Perkins, Crystal; Scannell, Brian P.; Brighton, Brian; Seymour, Rachel B.; Vanderhave, Kelly L.

doi:10.1016/j.injury.2015.07.031

Cited by 21 publications

(58 citation statements)

References 8 publications

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“…While other studies have documented the poor clinical and economic outcomes associated with firearm injuries, the current study extends these results by demonstrating robust differences in clinical and hospital utilization outcomes across firearm injury mechanisms among pediatric patients who arrived in the ED. Specifically, our results demonstrate that self‐inflicted injuries are associated with higher rates of death and higher hospital resource utilization compared to the violent or unintentional firearm injuries groups.…”

Section: Discussionsupporting

confidence: 68%

“…Several epidemiologic studies on pediatric firearm injuries have identified violence as the most common mechanism and found males and blacks at highest risk . Other studies found that pediatric patients treated in the ED for firearm‐related injuries have been shown to suffer high levels of morbidity and that most injuries occurred during the summer . A study of all pediatric injuries in Massachusetts showed firearm‐related injuries had the highest mortality rate of any injury mechanism …”

mentioning

confidence: 99%

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Predictors and Outcomes of Pediatric Firearm Injuries Treated in the Emergency Department: Differences by Mechanism of Intent

Monuteaux

Mannix

Fleegler

et al. 2016

Academic Emergency Medicine

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Objective: Firearm injuries among children are a major clinical and public health concern and one of the leading causes of pediatric fatalities. Our objective was to investigate differences in predictors and clinical outcomes between self-inflicted, violent, and unintentional pediatric firearm injuries for patients who present to pediatric emergency departments (EDs). Methods:We conducted a retrospective study of patients 0 to 21 years old treated in 37 pediatric academic EDs from 2004 to 2014. Patients were classified into the injury intent categories of self-inflicted, violent, and unintentional firearm injury using the International Classification of Diseases, 9th edition, Clinical Modification (ICD-9-CM) diagnoses and external causes of injury codes. Multivariable multinomial regression models compared groups.Results: We identified 9,628 firearm injuries from 2004 to 2014: 109 (1%) self-inflicted, 2,394 (25%) violent, and 7,125 (74%) unintentional. Male sex, increasing age, nonwhite race, public insurance, residing in an urban zip code, and lower zip code-level median household income were all independently associated with violent firearm injuries, relative to self-inflicted and unintentional injuries. Self-inflicted injuries were at the highest risk for hospital admission, death, intensive care unit services, surgical services, and increased length of stay, followed by violent injuries with intermediate risk and unintentional injuries at the lowest risk Conclusions: Self-inflicted, violent, and unintentional firearm injuries in children had distinct demographic risk factors and clinical and utilization outcomes. Targeted prevention and intervention efforts should be developed to reduce the incidence and severity of these injuries.ACADEMIC EMERGENCY MEDICINE 2016;23:790-795

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Section: Discussionsupporting

confidence: 68%

mentioning

confidence: 99%

Predictors and Outcomes of Pediatric Firearm Injuries Treated in the Emergency Department: Differences by Mechanism of Intent

Monuteaux

Mannix

Fleegler

et al. 2016

Academic Emergency Medicine

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“…This phenomenon mirrors rates of firearm violence. As such, initiatives that include retaliation-interruption campaigns,[36] wide initiatives implicating police and social agencies,[37] strict implementation of firearms laws,[3839] and prohibition of illegal firearm acquisitions[4041] are needed as they have all been shown to be beneficial prevention methods, at least provisionally, both for the people behind violent endeavors and for innocent citizens.…”

Section: Discussionmentioning

confidence: 99%

Gunshot injuries in Lebanon: Does intent affect characteristics, injury patterns, and outcomes in victims?

Zgheib

Shayya

Wakil

et al. 2019

J Emerg Trauma Shock

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Introduction: Lebanon lacks a national database of gunshot injuries (GSIs), which limits injury prevention initiatives. Objectives: This study examines patient characteristics, injury patterns, and clinical outcomes in GSI victims and evaluates the impact of intent on clinical outcomes with the aim of improving awareness among emergency department (ED) physicians about the importance of inquiring about intent to predict prognosis. Materials and Methods: We conducted a retrospective cohort study of GSI victims presenting to the ED of a tertiary care center in Beirut, Lebanon. Descriptive and bivariate analyses were done to identify differences based on intent. Results: A total of 83 patients were included, 59% with intentional GSI, 22% with unintentional GSI, and 19% with unspecified intent. They were mostly males (89.2%), with a mean age of 31.7 years, and mostly presenting during summer seasons. Females were more commonly victims of unintentional GSI. All victims sustaining multiple GSIs were in the intentional group. When compared to unintentional GSI, intentional and unspecified GSIs were found to result in more ICU admissions (46.9%, 31.3%, and 16.7%, P = 0.096), significantly longer hospital stays (18.2, 26.3, and 5.6 days; P = 0.001) and higher mortality (11.6%, 18.2%, and 6.7%; P = 0.747). The rates of surgical procedures were similar between the three groups although more victims of intentional and unspecified GSI underwent multiple surgeries. Conclusion: GSIs have different features, resource utilization, and clinical outcomes depending on the intentionality of injuries. All GSI victims suffer from substantial morbidity and mortality, but intentionally harmed victims sustain more severe injuries with worse outcomes.

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“…In 2009, 20 children were hospitalized every day for firearm injury, with the majority being males (Leventhal, Gaither, & Sege, 2014). Older children and adolescents (ages 13-17) may be more at risk for violent, intentional injuries by firearms, whereas younger children (10 and under) are more likely to sustain unintentional injuries (injuries occurred when a gun was accidently discharged during cleaning, hunting, playing with, or inspecting the weapon (Perkins, Scannell, Brighton, Seymour, & Vanderhave, 2016). Moreover, in 2014 firearm suicide and firearm homicide, respectively, were the third and fourth leading causes of death in children ages 10-14.…”

Section: Children and Firearm Injurymentioning

confidence: 99%

Social Work Practice and Gun Safety in the United States

Logan-Greene

Sperlich²,

Finucane³

2019

ASW

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Public policy debate about guns continues in the United States, with many professional organizations taking strong stands in policy statements. Moreover, many clinical organizations have provided recommendations for practitioners to use with clients to encourage gun safety in the home, particularly for vulnerable populations such as families with young children and those at risk of suicide. Social workers are in an excellent position to encourage gun safety with some of the most at-risk populations; however, clinical guidelines and research on preventing gun violence has lagged in social work compared to other disciplines. In this article we examine the importance of gun safety for social work clients (with special attention to families with children, families experiencing violence, and individuals at risk of suicide), consider the recommendations made by other professional organizations, and provide some initial thoughts about how social workers might engage with the families they serve to reduce the incidence of gun violence.

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Orthopaedic firearm injuries in children and adolescents: An eight-year experience at a major urban trauma center

Cited by 21 publications

References 8 publications

Predictors and Outcomes of Pediatric Firearm Injuries Treated in the Emergency Department: Differences by Mechanism of Intent

Predictors and Outcomes of Pediatric Firearm Injuries Treated in the Emergency Department: Differences by Mechanism of Intent

Gunshot injuries in Lebanon: Does intent affect characteristics, injury patterns, and outcomes in victims?

Social Work Practice and Gun Safety in the United States

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