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Children Caught In The Crossfire: A Decade Of Firearm Injuries
Anne Sescleifer1, Emily Onufer2, *Jose Greenspon1, *Martin Keller2
1Saint Louis University School of Medicine, St. Louis, MO;2Washington University in St. Louis School of Medicine, St. Louis, MO

Pediatric Trauma Society Abstract
Introduction: Firearm injuries (FIs) remain a significant cause of preventable morbidity and mortality in pediatric patients. In this study, we aim to define evolving trends and avenues for prevention.Methods: Following IRB-approval, medical records of patients presenting to our two State-Designated Level 1 Pediatric Trauma Centers in St. Louis, Missouri for treatment of FIs from 2010-2019 were retrospectively reviewed. Data was analyzed with Chi-Squared and Studentís T-test; p-value <0.05 was significant.Results: 1037 FI encounters from 1005 unique patients were included. 70.4% (n=730) were determined to be assaults, 26.1% (n=271) accidental, and 1.7% (n=18) self-inflicted injuries. Overall mortality was 4.5% (n=45). FI victims were most commonly African American (n=836, 80.6%), male (n=869, 83.8%), aged 13-17 (n=753, 72.6%), and from single-parent families (n=647, 62.4%). The incidence of FIs increased significantly over the last 5 years of the study (2010-2014, 6.8 FIs/month), compared to 2015-2019 (averaging 10.6 FIs/month, p<0.0001). Concurrently, FI related fatality increased from an average of 2.6 deaths/year (2010-2014) to 6.4 deaths/year (2015-2019, p=0.064). For the entire cohort, 12.1% (n=116) recidivists were identified. 75% of all FIs clustered in a single urban region (Figure).Conclusion: Pediatric FIs remain a significant concern, with high mortality rates. Violence and recidivism are geographically concentrated, with opportunity for targeted interventions.
FIGURE:


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