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Firearm Injuries and Children: Accidental Handgun Violence is the Leading Cause of Gun Related Trauma at an Urban Pediatric Trauma Center
Erik G. Pearson MD, Martha-Conley E. Ingram MD MPH, Callan B. Brownfield BS and Matthew T. Santore MD

Background: Firearm injuries remain an increasing cause of morbidity and mortality amongst America's youth. We reviewed firearm related injuries at the two Children's Hospitals in Atlanta over the last decade to determine causality.

Methods: All cases of pediatric trauma due to firearms between 2005-2016 treated at two urban trauma centers were queried from institutional trauma registries. Demographics, injury data, prehospital records, and clinical outcomes were reviewed to determine trends over a decade.

Results: Between 2005 and 2016, our centers saw 126 child victims of firearm related injury with an overall mortality of 9.6%. The median age was 10.2 years, 67% were male and 62% were African-American. The median Injury Severity Score (ISS) of 8 increased to 14 in 2015 (p=0.01) a year when the greatest number of children were shot (n=29) and killed (n=4). Accidental gun discharge was the most common cause of injury (72%) accounting for 50% of deaths due to gun violence. Children sustained a self-inflicted injury in 22% of cases and were victims of firearm-related injury from a sibling, parent, or friend in 35% of cases. Most commonly, injury occurred in the home (55%) and greater than half of these injuries were accidental.

Conclusions: Accidental handgun discharge is the leading cause of firearm-related injury and is most likely to occur in the home by a self-inflicted injury or by the hands of a family member or friend. Implementing public education about gun safety is needed to improve morbidity and mortality.

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