Firearm Injuries to Children and Teens Far More Deadly, Costly Than Other Injuries

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Natalie Krebs / The Chicago Bureau

Only 1 percent of 911 calls for injuries to children result from gunshots, but one in five of those children die, according to a recent study. Children injured by firearms were more likely to die than kids injured by any other means, including stabbings and car accidents.

The research did not study Chicago or the surrounding area, which has the nation’s highest homicide toll and counts many children who suffered gunshot wounds among the victims. Still the findings resonate here as Chicago tries to get a handle on a homicide rate that has shamed the city.

The research, instead, was published this month in the journal Pediatrics, comparing the rates, severity and costs of firearm injuries to those of other types of injuries in children and teens under age 19 in five geographical regions of the western U.S.

chicago-bureau-logo_JJIEsquareThe researchers examined cases leading to emergency services calls over a three-year period for 47 EMS agencies in five areas in Washington, Oregon, northern California and Colorado. Each region included metropolitan, suburban and rural communities.

The researchers categorized the nearly 50,000 injured children connected with EMS in the study into one of six categories: gunshot, cut/piercing/stabbing, car accidents, getting hit by a car, falls, blunt objects and “other.” They then tallied the costs per patient for each injury as well as the severity of the injury and the number of major surgeries and blood transfusions necessary for each injury type.

Children transferred to a hospital with a gunshot wound were four times more likely to die than children coming in with an injury in the next highest mortality category, piercings and stabbings. Eight percent of the children coming in with gunshot wounds died at the hospital, compare to 2 percent of those arriving with piercing wounds. Meanwhile, one third of the children who died from firearm injuries never reached the hospital before they died.

Those who survived sustained greater injuries and required more surgeries and blood transfusions than children injured by other mechanisms. “Gunshot injuries were more severe, requiring more frequent major therapeutic interventions and resulting in higher mortality and per-patient costs than any other injury mechanism,” the researchers wrote.

Gunshot victims accounted for just over one fifth of the children with the most severe injuries (23 percent), the largest category of all injury types. One third of the gunshot victims required major surgery — also the largest injury category represented even though only 1 percent of the total injuries to children resulted from firearms.

The bulk of gunshot injuries occurred to older teens, aged 15 to 19 (comprising 83 percent of all firearm injuries) and males (comprising 84.5 percent of total firearm injuries).

The total medical costs for treating gunshot victims averaged $28,510, almost double the next highest category for costs, car accidents, which cost an average $15,566 per patient. But these numbers represent only in-hospital costs and do not take into account costs from rehabilitation, lost productivity, physical therapy, mental health needs, follow-up visits or long-term outcomes.

The authors note in their background information that more than 29,000 children under age 19 died from gunshots from 2001 to 2010. The current annual numbers are actually an improvement from a 1994 peak in gun violence among children and teens. By 2003, the death rate had dropped by more than half and then stalled, though the authors suggest at least one avenue for improved prevention efforts.

“Lessons in improving car motor vehicle safety (eg, booster seats, age-appropriate restraint systems and seat position, air bags) and the associated reductions in pediatric motor vehicle mortality provide important examples of the potential impact of injury prevention efforts,” they wrote.

“The gains in motor vehicle safety required rigorous research to understand the problems, partnerships with national organizations (eg, National Highway Traffic Safety Administration) and the automotive industry and evidence-based legislation,” they wrote. “Reducing gunshot injuries in children will likely require similarly broad-based, interdisciplinary efforts, in addition to rigorous research.”

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