Dr St Christopher's Hospital for Children Drexel University College of Medicine Philadelphia, Pennsylvania, United States
Background: Trauma and suicide, including those caused by firearms, are among the top five causes of death in the pediatric population in the United States. International studies have shown that over 90% of firearm deaths in high-income countries among children aged 0-14 years old occur in the United States, making firearm injuries a serious pediatric and public health problem nationally. While various institutions look to characterize the population affected by gun violence in inner cities, few studies look at children. Cities like Philadelphia, however, have seen a 148% increase in the number of pediatric gunshot wounds (GSW) since 2015.
Objective: We evaluated the presentations of all patients with GSWs to an urban pediatric Level 1 trauma emergency department (ED) in North Philadelphia over a seven-year period to characterize the demographics of those injured, severity of injury and sequelae, and the motivation of injuries.
Design/Methods: We conducted a retrospective analysis of all patients who presented to our ED between January 1, 2013 and May 31, 2020 for evaluation of GSW. We recorded demographic information, incident location, incident motivation (if known), and initiation of trauma protocol.
Results: 227 patients charts were evaluated over a 7 year period. Patient age ranged from 2 to 58 years (mean 15 yrs, mode 16 yrs), and 79.7% were male. Patients were 53% Black, 20% Hispanic, 6% White, 1% Asian, and 19% “Other Race”. Trauma protocol was initiated in the ED for 75% of patients. Predominant motivations were “bystanders of shooting” (44.6%), unknown motivation (37.5%), drug-related violence (8.9%), accidental injury (8%) and interpersonal conflict (6.25%). Other motivations included suicide, police-related injuries and interpartner violence. Of those injured as bystanders, the average age was 13.6 years. 33.3% of victims were shot at their home address. Conclusion(s): These findings represent the first demographic characterization of pediatric GSW injuries in North Philadelphia. They underscore a low mean victim age, a predominance of Black and Hispanic victims, and an appreciable number of victims who were bystanders or in their own homes. This study offers evidence to support urgent and increased prevention strategies to reduce ongoing firearm violence.
Authors/Institutions: Uma Raman, Drexel University College of Medicine, Philadelphia, Pennsylvania, United States; Jennifer Nhan, Drexel University College of Medicine, Philadelphia, Pennsylvania, United States; Kajsa Vlasic, Drexel University College of Medicine, Philadelphia, Pennsylvania, United States; Anisha Gopu, Drexel University College of Medicine, Morganville, New Jersey, United States; Kerri-Anne Ciesielka, Drexel University School of Public Health, Plymouth Meeting, Pennsylvania, United States; Jeremiah Goldstein, Drexel University College of Medicine, Philadelphia, Pennsylvania, United States; Angela Kim, Drexel University College of Medicine, Philadelphia, Pennsylvania, United States
