Trends in Musculoskeletal Injuries Due to Firearms in Pediatric Patients: A Retrospective Study

Abstract

Abstract Background Firearm injuries (FIs) are a substantial cause of mortality and morbidity in children. As physicians may have a role in preventing these injuries, understanding the epidemiology and identifiable risk factors associated with these injuries is important. The primary objective of this study is to assess for longitudinal trends in demographics and circumstance of injury (e.g., assault, accident, self-inflicted) in pediatric and adolescent FIs across different geographical regions in the United States. Secondary objectives included assessing the severity of outcomes and quality-of-care measures based on the nature of injury, including anatomical location and the presence of concomitant nerve injury. Methods Data was utilized from admissions between 1997–2019 available in Kids’ Inpatient Database (KID), a nationwide database of pediatric and adolescent inpatient care admissions. All patients aged 20-years-old (y.o.) or younger with a firearm-associated injury were included in our study. Multi-level generalized linear models were employed to evaluate differences in categorical characteristics (e.g., race, circumstance of injury, geographical region) across time points. Results The majority of FIs in our study were 16–20 y.o., with over half due to assaults. Between 2000–2019, the probability of an FI due to an accident nearly quadrupled in Black and Hispanic patients. Between 2000–2019, the number of FI admissions in the Northeast decreased from .75 to .64, while the Midwest increased from .16 to 1.02 per, 100,000 people. Conclusions Our data indicates significant heterogeneity in the pattern of musculoskeletal injuries resulting from FIs. Recognizing this may allow physicians to improve counseling for patients and advocate for the best policies within the areas they serve. Future research should assess the efficacy of provider specific programs geared towards preventing these injuries.