Pediatric Firearm Injury Emergency Department Visits From 2017 to 2022: A Multicenter Study

Jennifer A. Hoffmann, Division of Emergency Medicine, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL.
Camille P. Carter, Department of Pediatrics, University of Utah, Salt Lake City, Utah.
Cody S. Olsen, Department of Pediatrics, University of Utah, Salt Lake City, Utah.
Pradip P. Chaudhari, Division of Emergency and Transport Medicine, Children's Hospital Los Angeles, Department of Pediatrics, Keck School of Medicine of the University of Southern California, Los Angeles, California.
Sofia Chaudhary, Division of Emergency Medicine, Department of Pediatrics and Department of Emergency Medicine, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia.
Susan Duffy, Departments of Emergency Medicine and Pediatrics, Brown University, Hasbro Children's Hospital, Providence, Rhode Island.
Nicolaus Glomb, Department of Emergency Medicine, Division of Pediatric Emergency Medicine, University of California, San Francisco, San Francisco, California.
Monika K. Goyal, Division of Emergency Medicine, Children's National Hospital, George Washington University, Washington, District of Columbia.
Jacqueline Grupp-Phelan, Department of Emergency Medicine, Division of Pediatric Emergency Medicine, University of California, San Francisco, San Francisco, California.
Maya Haasz, Department of Pediatrics, Section of Emergency Medicine, Children's Hospital Colorado, University of Colorado, Aurora, Colorado.
Bijan Ketabchi, Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio.
Nicole Kravitz-Wirtz, Department of Emergency Medicine, University of California, Davis, Sacramento, California.
E Brooke Lerner, Department of Emergency Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York.
Bashar Shihabuddin, Division of Emergency Medicine, Nationwide Children's Hospital, Columbus, Ohio.
Wendi Wendt, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin.
Lawrence J. Cook, Department of Pediatrics, University of Utah, Salt Lake City, Utah.
Elizabeth R. Alpern, Division of Emergency Medicine, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL.

Document Type

Journal Article

Publication Date

12-1-2023

Journal

Pediatrics

Volume

152

Issue

6

DOI

10.1542/peds.2023-063129

Abstract

BACKGROUND AND OBJECTIVE: Pediatric firearm injuries increased during the coronavirus disease 2019 pandemic, but recent trends in firearm injury emergency department (ED) visits are not well described. We aimed to assess how pediatric firearm injury ED visits during the pandemic differed from expected prepandemic trends. METHODS: We retrospectively studied firearm injury ED visits by children <18 years old at 9 US hospitals participating in the Pediatric Emergency Care Applied Research Network Registry before (January 2017 to February 2020) and during (March 2020 to November 2022) the pandemic. Multivariable Poisson regression models estimated expected visit rates from prepandemic data. We calculated rate ratios (RRs) of observed to expected visits per 30 days, overall, and by sociodemographic characteristics. RESULTS: We identified 1904 firearm injury ED visits (52.3% 15-17 years old, 80.0% male, 63.5% non-Hispanic Black), with 694 prepandemic visits and 1210 visits during the pandemic. Death in the ED/hospital increased from 3.1% prepandemic to 6.1% during the pandemic (P = .007). Firearm injury visits per 30 days increased from 18.0 prepandemic to 36.1 during the pandemic (RR 2.09, 95% CI 1.63-2.91). Increases beyond expected rates were seen for 10- to 14-year-olds (RR 2.61, 95% CI 1.69-5.71), females (RR 2.46, 95% CI 1.55-6.00), males (RR 2.00, 95% CI 1.53-2.86), Hispanic children (RR 2.30, 95% CI 1.30-9.91), and Black non-Hispanic children (RR 1.88, 95% CI 1.34-3.10). CONCLUSIONS: Firearm injury ED visits for children increased beyond expected prepandemic trends, with greater increases among certain population subgroups. These findings may inform firearm injury prevention efforts.

Department

Pediatrics

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