Comparison of Pediatric and Adult Firearm Deaths to Inform Violence Prevention at Pediatric Trauma Centers

Abstract

Introduction

Hospital-based violence intervention programs primarily target adults, raising questions about the effectiveness in preventing pediatric firearm deaths. We hypothesized that pediatric and adult firearm injury deaths are different enough to require unique intervention strategies.

Methods

Retrospective chart review was conducted of medical examiner and trauma center records of firearm-related deaths in the largest metropolitan county in Texas. Data from pediatric patients (0-17 ys) were compared to adults using chi-squared, Fischer's exact test, and Wilcoxon’s rank-sum tests. In addition, data from younger children (0-15 ys) were further stratified and compared to adults (16 and above) using similar analyses.

Results

During 2018-2020, 117 pediatric and 1803 adult firearm deaths were identified. Homicide was most common in both groups (ped 58% versus adult 41%); however, differences were noted in unintentional shootings (ped 16% versus adult 1%, P < 0.01) and suicides (ped 21% versus adult 34%, P < 0.0 L). Alcohol abuse was more common in adults (ped 10% versus adult 46%, P < 0.01). Children <16 ys had a higher incidence in females (<16y 24% versus 16y+ 12%, P < 0.01), less alcohol abuse (<16y 6% versus 16y+ 62%, P < 0.01), less illegal drug use (<16y 19% versus 16y+ 46%, P < 0.01), and were more commonly killed at home (<16y 60% versus 16+y 43%, P < 0.01). Prevalent victim residence zip codes differed between children and adults.

Conclusions

Adult and pediatric firearm deaths differ in shooting intent and many key risk factors. These data can strategically inform focus areas for pediatric hospital-based violence intervention programs as well as resource allocation based on regional-level data.