Tuesday, April 5, 2016

Pediatric Gunshot Wound Recidivism: Identification of At-Risk Youth

BACKGROUND:
Although penetrating injury is the most common reason for pediatric trauma recidivism, there is a paucity of literature specifically looking at this population. The objective of this study was to identify those in the pediatric community at the highest levels of risk for suffering GSW on multiple occasions.

METHODS:
A retrospective review querying our urban level 1 trauma database was performed. Patients aged 0-18 sustaining GSW from 2000 to 2011 were selected. This was further refined to include those who returned to the hospital for another firearm injury. Demographic data, including age of initial and subsequent presentation, gender, race, zip code, home address, and disposition were compiled.

RESULTS:
Over the 12 year study period 896 pediatric patients were discharged from the hospital after initial firearm injury with subsequent 8.8 % recidivism rate. All recidivists were male with and 86% were 16-18 at the time of first injury. The subsequent incident occurs within the first year, two years, or three years 32%, 53% and 66% of the time respectively. 9 individuals in our study group suffered GSW on three separate occasions with a mortality rate of 22%. Regarding the domicile, 53 % of the patients were located in a 3 square mile area containing four public high schools.

CONCLUSION:
Utilizing demographic data we have been able to identify a at-risk population where there is a greater than a one in twelve chance of getting shot multiple times. Utilization of this type of demographic data can help target those at highest risk by allocating resources that can have the greatest impact on this societal burden.

LEVEL OF EVIDENCE:
Level 3 Prognostic.

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