Children and adolescents who are injured by firearms are more likely than youth who have injuries resulting from other causes to require intensive care and to die, according to an analysis published in JAMA today.
As state and federal legislators debate the merits of new legislation to curb gun violence, public health leaders have lamented the lack of research available to guide policy makers to the most effective means to reduce gun-related injuries. As Arthur L. Kellermann, MD, MPH, and Fredrick Rivara, MD, MPH, recently noted in a JAMA Commentary, public health research has helped substantially reduce deaths from car crashes, drowning, and fires, but a 17-year moratorium on federal funding for firearms research has stymied investigation of gun violence and how to best prevent it.
The new study provides some insights on gun-related trauma among children and adolescents between the ages of 4 and 17 years who were treated at 2 level 1 trauma centers in Colorado between 2000 and 2008. The researchers found that firearms were involved in 1.9% of the 6920 youth injuries they analyzed over that period. These young patients with firearm-related injuries were more likely to require intensive care (50.4%) compared with individuals with other causes of injury (19.3%); they also were more likely to die (13.2%) as a result of their injuries than those with other types of trauma (1.7%). Youths with firearm-related injuries were more likely than those with other types of injuries to be adolescent males and to have self-inflicted wounds.
Angela Sauaia, MD, PhD, associate professor of public health and surgery at the University of Colorado, discussed the findings with news@JAMA.
news@JAMA: Why did you decide to do the study?
Dr Sauaia: We initially decided to do a study on playground injuries, but we realized as we coded injuries [in the trauma registries] that there was a morbid pattern of violence among youth specifically with firearms.
news@JAMA: How do your findings compare with previous studies?
Dr Sauaia: There are few studies on pediatric injuries; most are just a snapshot in time, 1 year or 1 center. This is one of the few studies looking at temporal trends.
news@JAMA: What do you think your findings tell us about the role of firearms in injuries among youth?
Dr Sauaia: Firearm injuries in children are not isolated tragedies; they are part of the routine of ER physicians and trauma surgeons.
news@JAMA: How are these gun-related injuries different from other types of injuries?
Dr Sauaia: They are more severe, they demand more health care, and they claim more lives.
news@JAMA: Do you think the findings would likely be different in other regions?
Dr Sauaia: Possibly. I’m not optimistic that results would be much different.
news@JAMA: What further research is needed?
Dr Sauaia: So much more research is needed to understand better how we can prevent firearm injuries. One obvious place to start, regardless of where you stand on gun possession, is that a number of these adolescents who were injured had access to an unsecured and loaded firearm. And that is something we can all agree to work on.
news@JAMA: What do you think is the main take-home message?
Dr Sauaia: The main message is gun injuries among youth are not an isolated tragedy. Firearm injuries kill more than any other types of injury, many are self-inflicted, and many can be prevented by not allowing youth access to unlocked and loaded guns.