Citation

Haasz M, Dulchavsky A, Stevens J, Nolan M, Leonard J, Phillips R, Knoepke C, Schroeppel T, Zuk J, Abbey W, Ambroggio L. J. Trauma Acute Care Surg. 2023; ePub(ePub): ePub.

Copyright

(Copyright © 2023, Lippincott Williams and Wilkins)

DOI

10.1097/TA.0000000000004090

PMID

37335171

Abstract

BACKGROUND: Firearms are a leading cause of injury among US youth. There is little research describing outcomes after pediatric firearm injuries, particularly past one year.

OBJECTIVE: Assess long-term physical and mental health outcomes among non-fatal firearm versus motor vehicle collision (MVC) injured victims and versus a standard population.

METHODS: We retrospectively identified firearm and MVC-injured pediatric patients seen at one of our four trauma centers (01/2008-10/2020), and prospectively assessed outcomes using validated patient reported outcome measures. Eligible patients were English-speaking, injured ≥5 months prior to study start, <18-years-old at time of injury and ≥ 8-years-old at study start. All firearm patients were included; MVC patients were matched 1:1 with FA patients for injury severity score (ISS) (dichotomized < or ≥ 15), age range (+/- 1 year), and year of injury. We conducted structured interviews of patients and parents using validated tools (Patient-Reported Outcomes Measurement Information System tools (PROMIS), Children's Impact of Event Scale for <18 and parent-proxies). PROMIS scores are reported on a T-score metric (mean = 50; SD = 10); higher scores indicate more of the measured domain. We used paired T-tests, Wilcoxon Signed Rank tests, and McNemar's test to compare demographics, clinical characteristics, and outcomes.

RESULTS: There were 24 participants in each of the MVC and firearm injured groups. Compared to MVC-injured patients, firearm-injured patients <18-years-old had similar scores, and firearm-injured patients ≥18-years-old had higher anxiety scores (59.4 (8.3) vs 51.2 (9.4)). Compared to a standard population, patients <18-years-old had worse global health scores (mean:43.4 (SD:9.7)) and participants ≥18-years-old reported increased fatigue (61.1 (3.3)) and anxiety (59.4 (SD:8.3)).

CONCLUSION: Long term effects of firearm-injured patients were poorer than matched MVC and the standard population in few domains. Further study in a larger, prospectively recruited cohort is warranted to better characterize physical and mental health outcomes. STUDY TYPE: Brief Report. LEVEL OF EVIDENCE: Level 2.

Language: en