333 - Pediatric Gunshot Incidents: A decade of experience at a children's hospital

The last decade was marked by rising rates of children impacted by gun violence. The Center for Disease Control and Prevention acknowledges it as a serious health threat. The objective of this study was to expand on the work of a few hospital systems that have conducted retrospective analysis on pediatric patients presenting with firearm trauma to their Emergency Department (ED) and analyze trends by investigating the circumstances of ED visits at Akron Children’s Hospital (ACH) between January 1, 2012, and June 30, 2022.

Objective: The primary aims of the study were to determine if pediatric patients in the greater Akron area are experiencing more gun violence, and to analyze related factors.

Design/Methods:

This was a retrospective, IRB approved study of pediatric patients (under age18), presenting with firearm related trauma to an ACH ED. Data extraction was done by the ACH Research Institute.  Each case was reviewed. Trend data was evaluated using the Cochran-Armitage Trend test. Demographic variables were evaluated using Chi-Square analysis with the entire ED population as the reference.

Results:

There were 186 cases of a pediatric patient presenting with firearm related trauma. There was a significant rising trend from 2012 to 2022, with an exacerbation during the pandemic. The highest annual rate was 50 cases of firearm injury per 100,000 ED visits in 2020. A significant majority of these cases were the result of assaults experienced by Black, male, teenagers living within an urban zip code. The upper/lower extremities were the most common injury location. Assaults were 66% of cases, accidents accounted for 27% of cases, and self-inflicted/suicide attempt accounted for 4% of cases. There were 11 deaths, or 6% of cases. 62% were hospitalized with an average stay of 3.4 (±8.8) days, 38% of cases required surgery, and 23% had a PICU admission. 62 patients (33%) were discharged from the ED.

Conclusion(s):

This study of pediatric patients presenting with firearm related trauma to an Akron Children’s Hospital ED demonstrated a significant increasing trend of firearm related ED cases between 2012 and 2022 that had the highest rate of 50.0 cases per 100,000 ED visits in 2020, during the peak of the pandemic. The results of this study may provide valuable insight into this public health crisis for Northeastern Ohio and other similar areas, as Akron Children’s Hospital is in a midsize city and serves both an urban and rural population.