A Comparative Analysis of Zip Code Discordance in Pediatric Gunshot Wounds

Introduction

With the rate of pediatric gun violence rising, it is imperative to investigate current trauma intervention strategies. For example, previous trauma studies have used zip codes of residence as a proxy for the zip code of injury. This study aims to look at relationships between zip codes of injury and residence specifically in pediatric patients with gunshot wounds.

Methods

A retrospective review was performed on two trauma registries: one children's hospital and one primary adult hospital in an urban city. Pediatric patients <15 y old with a gunshot wound from January 2016 to April 2023 were included. Zip code discordance (ZCD) was defined as the patient's zip code of injury differing from their zip code of residence; associations between ZCD and clinical variables were analyzed.

Results

Of the 238 patients included in this study, ZCD was observed in 40.3% of patients. Overall, there was a predominance of non-Hispanic, Black males; however, there were significantly more Black patients with ZCD (92.7% versus 79.6%, P = 0.02). Adjusted analysis revealed that ZCD was associated with a longer hospital length of stay (odds ratio 1.41, 95% confidence interval 1.19-1.67, P < 0.01) and a higher likelihood of mortality (odds ratio 6.79, 95% confidence interval 2.39-23.1, P < 0.01).

Conclusions

These findings reveal differences between pediatric patients with and without ZCD, emphasizing the importance of accurate zip code reporting. Future studies should investigate why the associations between ZCD and clinical outcomes occurred.