Pediatric Trauma Society

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Community Intervention Strategies May Reduce Recidivism and Mortality in Pediatric Victims of Penetrating Trauma
Faidah O Badru, Yana Puckett, Saurabh Saxena, Anne Sescleifer, Kena Vyas, Jose Greenspon, *Colleen Fitzpatrick, Gustavo Villalona, Kaveer Chatoorgoon
Cardinal Glennon Children's Hospital, St Louis, MO

Background: Penetrating trauma victims are often at a higher risk of recurring violent trauma and mortality. The aim of this study is to evaluate if a community based intervention helps to reduce this risk in pediatric penetrating trauma victims.
Methods: Patients managed for non-fatal penetrating trauma between 2000 and 2015 were retrospectively reviewed. Variables abstracted included demographics, circumstance of injury, and enrollment into an intervention program, recidivism, and mortality.
Result: A total of 678 patients met inclusion criteria. Median age was 15 years and 80.1% were males. African Americans constituted 81.6%, 73.2% were from single parent households and 46.8% required admission. Gunshot wound (GSW) constituted 73.8% of all injuries. GSW to the extremity was the most common (52%). The rate of subsequent death after sustaining a GSW was 5.9% (40), with 83.8% being homicides. Average time to death was 1.6 years. There were no differences in the likelihood of subsequent death based on demographics, socioeconomic factors or injury circumstance (p > 0.05). Successful participation in a community-based whole family intervention, called better family life, was associated with significant reduction in repeat penetrating trauma (0% vs 13.4%) and subsequent mortality (0% vs 6.2%).
Conclusion: Injury recurrence in this population is a significant concern, with nearly 6% of pediatric patients who sustain penetrating trauma dying within 2 years of their initial trauma. Community intervention programs may help reduce repeat penetrating injuries and mortality. Early referral should be considered.

Intervention participants
( n = 21)
No intervention
(n = 406)
P value
Median Age16yrs15yrs0.14
Gender, M81%80.5%1.0
Race, AA95.2%76.6%<0.0001
Admitted52.4%41.4%0.03
Repeat penetrating trauma0%13.4%
Subsequent mortality0%6.2%


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