Location Matters: Pediatric Firearm Injury Visits by Trauma Center Type
Gretchen J Cutler, Alicia L Zagel, Amy M Linabery, Alicen B Spaulding, Anupam B Kharbanda
Children's Minnesota, Minneapolis, MN
Background: Firearm injuries (FI) are a leading cause of death and disability in children but there is a lack of information on differences in patient characteristics by trauma center type.
Methods: We examined patients less than 19 years of age treated at trauma centers contributing to the National Trauma Data Bank, years 2009-2014. Trauma centers were categorized as pediatric only, combined adult and pediatric, or adult only based on state or American College of Surgeons certification level. Chi-square tests were used to examine differences in patient characteristics by trauma center type.
Results: We examined 756,773 pediatric trauma patients, of which 26,700 (3.5%) sustained a FI. The majority of FI were classified as assault (74.7%), followed by unintentional (15.5%) and self-inflicted (5.3%). The majority of patients visited centers with adult (62.2%) or combined (30.1%) certification, while only 7.0% visited pediatric only centers. Intent of FI differed significantly by trauma center type, with adult or combined centers seeing more assault injuries (76.1% vs. 58.1%, p <.0001), and pediatric only centers seeing more unintentional injuries (31.9% vs. 14.1%, p <.0001).
Conclusion: The majority of pediatric patients with FI are being seen at trauma centers with no pediatric certification. Emergency departments are an ideal location to identify at-risk youth and target modifiable risk factors. Information on patient characteristics by trauma center type will be crucial to help guide FI prevention efforts and best practices.
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