Outcomes in children and young adults who are hospitalized for firearms-related injuries
Outcomes in children and young adults who are hospitalized for firearms-related injuries
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DOI：
10.1542/peds.113.5.1306
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发表时间：
2004-05-01
期刊：
影响因子：
8
通讯作者：
Sege, R
中科院分区：
文献类型：
--
作者：
DiScala, C;Sege, R
目标。比较住院人群（新生儿至19岁）非致命性枪支相关伤害的结果，并估计全国随后致残的发生率。采用chi(2)、优势比和t检验对来自美国消费品安全委员会国家儿童创伤登记处（NPTR）和国家电子伤害监测系统的数据进行描述性统计和比较分析。研究了患者的人口学特征、伤前病史、伤现场、伤的主要部位、伤的严重程度、资源的利用、短期和长期残疾、残疾的医学原因以及出院时的处理。非故意NPTR （n = 268）和攻击相关枪支相关伤害（n = 506）进行比较。在两组中，大多数患者为男性（80%）。与意外受伤的儿童相比，被侵犯的儿童年龄较大，黑人更常见（59.3%对32.5%）。两组中约有17%的人在受伤前有医疗/社会心理问题史。意外伤害主要发生在私人住宅（75.7%），袭击主要发生在公共场所/街道（53.8%）。在两组中，多部位损伤都很普遍，并且相当大比例的持续损伤为严重至危重程度。大多数儿童是由救护车运送的，但在非故意的群体中，有很大一部分是由直升机运送的。两组的重症监护病房入院率相似，均为40%。意外伤害组手术干预率（66.8%比50.8%）高于被侵犯组，住院时间（中位数：5天比3天）更长。两组中几乎有一半的儿童因残疾出院，87%的儿童回到了他们的家。将NPTR致残率应用于国家电子伤害监测系统对住院治疗的估计表明，全国每年约有3200名儿童因枪支相关伤害而致残。儿童非致命性火器相关伤害与医疗资源的高使用率和持续性残疾有关。应该制定和实施公共政策，以减少这些灾难性事件的发生。
Objectives. To compare outcomes by intent of nonfatal firearms-related injuries in a hospitalized population, newborn to 19 years of age, and estimate the national incidence of ensuing disability.Methods. Descriptive statistics and comparative analysis using chi(2), odds ratio, and t test were applied to data from the National Pediatric Trauma Registry (NPTR) and the National Electronic Injury Surveillance System of the US Consumer Product Safety Commission. Demographics, preinjury medical history, scene of injury, primary body part injured, severity of injury, utilization of resources, short-term and long-term disability, medical cause of disability, and disposition at discharge were studied.Results. NPTR unintentional (n = 268) and assault-related firearms-related injuries (n = 506) were compared. In both groups, the majority of patients were male (80%). Compared with the unintentionally injured, the assaulted children were older and more frequently black (59.3% vs 32.5%). Approximately 17% in both groups had a preinjury history of medical/psychosocial problems. Unintentional injuries occurred mainly in private dwellings (75.7%), and assaults occurred in public places/street (53.8%). In both groups, injuries to multiple body regions were prevalent, and a substantial proportion sustained injuries of serious to critical level. Most children were transported by ambulance, but a significant proportion in the unintentional group were transported by helicopter. The rate of admission to the intensive care unit was similar to40% for both groups. The unintentionally injured had a higher rate of surgical intervention (66.8% vs 50.8%) and stayed in the hospital longer than the assaulted ones (median: 5 days vs 3 days). Almost half of the children in both groups were discharged with disability, and similar to87% returned to their home. Applying the NPTR disability rate to National Electronic Injury Surveillance System estimates of hospitalization suggests that similar to3200 children nationwide develop disability from firearms-related injuries annually.Conclusions. Nonfatal firearms-related injuries in a pediatric population are associated with a high use of medical resources and lasting disability. Public policies should be developed and implemented to reduce the occurrence of these catastrophic events.