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Pediatric Firearm Injuries And Fatalities: Do Racial Disparities Exist?
*Joseph Sakran1, *Michael Nance2, Taylor Riall3, *Samer Asmar3, *Mohamad Chehab3, *Bellal Joseph3
1Johns Hopkins Univeristy, Baltimore, MD;2Children's Hospital of Philadelphia, Philadelphia, PA;3University of Arizona, Tucson, AZ

OBJECTIVE(S): Pediatric firearm-related morbidity and mortality are rising in the United-States. There is a paucity of recent data describing racial disparities in pediatric firearm victims. The aim of our study is to evaluate the racial disparities in outcomes among pediatric firearm injury patients.
METHODS: We analyzed the 2017 Pediatric Trauma Quality Improvement Program (PTQIP) including patients aged ≤17y with firearm injuries. We stratified our sample by race: Whites and African Americans. Primary outcomes were length-of-stay (LOS) and in-hospital mortality. Secondary outcomes were mode of transport, injury intent, weapon utilized, and discharge disposition. Multivariable Cox regression was performed.
RESULTS: A total of 119,553 patients were identified, of which 3,727 suffered from firearm injuries (1,228 White and 2,499 African Americans). Mean age was 14±4y, 84% were male, and ISS was 5[1-16]. LOS was not different between the two groups, but mortality was higher in Whites as compared to African Americans (p-value<0.01). Assault was more common in African Americans, while suicide/self-harm and unintentional-injuries were more common in Whites (p-values< 0.01). Table 1. On Cox regression analysis, White race was associated with a higher mortality (HR 1.8[1.3-2.4] p<0.01), after adjusting for age, gender, ISS, body-regions-AIS, trauma center level, vitals, and transfusions.
CONCLUSIONS: Firearms continue to be a source of morbidity and mortality in children. Racial disparities exist between the AA and white population offering opportunities to develop prevention initiatives.
Table 1. Outcomes of the two Racial Groups
OutcomesWhite
(N=1,228)
African Americans
(N=2,499)
P-Value
Length of Stay, median [IQR]1.6 [0.4-4.6]1.6 [0.4-4.6]0.68
Mortality, %114.4<0.01
Intent of Injury, %
Unintentional35.221.2<0.01
Assault45.577.1<0.01
Suicide/Self Harm141.1<0.01
Type of Weapon Utilized, %
Handgun45.740<0.01
Shotgun7.11.6<0.01


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