Louise Eisenhardt Resident Travel Scholarship Award: Regional and Socioeconomic Factors Impacting Pediatric Victims of Cranial Gunshot Wounds: Analysis of the Kids’ Inpatient Database (KID)

Introduction: Injury by firearms among the pediatric population is a growing concern in the United States. We sought to identify and characterize demographic factors associated with pediatric cranial gunshot wounds (GSW).

Methods: A query of the 1997-2019 KID databases, including patients under 21 years, was run for cranial GSW ICD-9 and ICD-10 codes. ANOVA and chi-squared tests were performed to analyze demographics and outcomes by injury type.

Results: Our query resulted in 2990 patients with cranial GSW; 86.1% were male. Mean age was 16.48 years; accidental GSW victims were the youngest and intentional GSW the oldest (14.88±5.2 versus 17.2±2.3, p< 0.001). Blacks, Hispanics, and Asian Pacific Islanders were most commonly victims of assault; Whites were most commonly victims of intentional GSW (p < 0.001). All victims were most likely to have Medicaid except for intentional victims who were more likely to have private insurance (p < 0.001).

Assault GSW was the predominant injury type in all regions, with most in the West (33.7%). The South had the most accidental (51.9%) and intentional (44.6%) injuries. Assault occurred more in the most densely populated regions; intentional and accidental injuries in less dense regions. In the 1997 and 2019 populations predominant GSW type was accidental; in all other years assault predominated.

Accidental victims were most likely to undergo craniotomy and intentional were least likely (p < 0.001). Inpatient mortality was 46.4% with intentional victims having the highest rate (68.6%) followed by undetermined (60.3%) and law enforcement-related GSW (57.7%). After death the most common disposition was home (26.5%), with assault victims being the most likely to go home (p < 0.001).

Conclusion : Victims of assault were more likely to be Black, Hispanic, or Asian Pacific Islander and reside in densely populated regions. Understanding socioeconomic factors is crucial for developing targeted prevention strategies to mitigate morbidity and mortality from pediatric gun violence.