Purpose: Gunshot wounds (GSWs) are the second most common cause of traumatic pediatric deaths nationwide. Using data from a mostly rural catchment area, we identified clinical trends of unintentional pediatric GSWs and determined geographical and age-based foci for intervention.
Methods: Retrospective review of our institution trauma registry (2000-2015) identified all pediatric patients admitted for unintentional GSWs. Demographics, patterns of injury, and outcomes were evaluated. Incidence rates were then collated by location to create geographic representations (“heat maps”) of cases in the catchment area.
Results: 194 children (79.4% male, 72.0% African American) sustained unintentional GSWs, with mean age of 10.7±4.6 years. Most common firearm was a handgun (54.2%), followed by a pellet gun (24.7%) and a hunting rifle (5.3%). Mean hospital stay was 4.7 days, with median Injury Severity Score of 5 and most common injury site being the extremity. Young teenagers (10-14 years) were most likely to experience an unintentional GSW, with rates more than twice those of other age groups. Younger age groups were associated with higher mean ISS at presentation (p=0.011), though no difference in mortality rates (p=0.898) or length of hospitalization (p=0.449) were observed. Geographic evaluation, demonstrated unintentional GSW rates increasing as one approached urban centers of population.
Conclusion: Children 10-14 years old are most likely to experience unintentional GSWs, most often by handguns, with the likelihood of such traumas increased in peri-urban areas. Using the resulting heat maps of our catchment area, we established the most effective areas and populations to be targeted for preventative intervention.
