美国小儿枪伤流行病学:2019年冠状病毒疾病大流行期间枪伤率的变化。

IF 1.4 3区 医学 Q3 ORTHOPEDICS
Journal of Pediatric Orthopaedics Pub Date : 2024-10-01 Epub Date: 2024-06-10 DOI:10.1097/BPO.0000000000002742
Arakua Welbeck, Beltran Torres-Izquierdo, Mehul M Mittal, David Momtaz, Rishi Gonuguntla, Ndéye Guisse, Jesse Hu, Daniel E Pereira, Pooya Hosseinzadeh
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引用次数: 0

摘要

目的:儿科弹道伤害已成为美国的公共卫生危机。儿童枪支伤害的激增超过了其他死亡原因。本研究旨在评估过去十年中儿科枪伤(GSI)的趋势,并调查大流行病对 GSI 统计数据的影响(如果有的话):方法:我们使用一个联合、实时的国家数据库进行了全面的回顾性分析。在 2017 年至 2023 年期间,共有 15267921 名儿童未患 GSI,6261 名儿童患 GSI。该研究评估了不同人群中 GSI 的发病率和年度比例。此外,还分析了每 10 万人中意外、非意外、骨折相关和致命 GSI 的发病比例:从 2017 年到 2023 年,每十万人中 GSI、意外 GSI、非意外 GSI、致命 GSI、坐轮椅病例和骨折相关 GSI 的发病比例显著增加,从 9.7 增加到 22.8(相对风险:2.342,95% CI:2.041,2.687,P <0.001)。与大流行高峰期 2021 年的非意外 GSI(发病比例 25.8 vs 2.1;P <0.001)相比,总体增长主要是意外 GSI 的结果。在意外GSI患者中,2017年至2023年间每10万人的发病比例从8.81上升至21.11(相对风险:2.397,95% CI:2.076,2.768,P <0.001):这项研究表明,儿童死亡的主要原因已从机动车事故转变为GSI,尽管2019年冠状病毒疾病大流行,但儿童死亡率仍在持续上升。意外伤害在 GSI 中占大多数,这表明需要加强枪支安全措施,包括要求枪支存放、枪支上锁且不装子弹、要求在有枪支的家庭中对儿童进行监护,以及执行更严格的惩罚措施。要解决这一公共卫生危机,需要做出全面的努力。儿科医生在为家庭提供枪支安全咨询和教育方面发挥着至关重要的作用:证据等级:三级。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Epidemiology of Pediatric Firearm Injuries in the United States: The Progression of Gunshot Injury Rates Through the Coronavirus Disease 2019 Pandemic.

Objectives: Ballistic injuries among pediatric populations have become a public health crisis in the United States. The surge in firearm injuries among children has outpaced other causes of death. This study aims to assess the trend in pediatric gunshot injuries (GSIs) over the last decade and investigate the impact, if any, of the pandemic on GSIs statistics.

Methods: A comprehensive retrospective analysis was conducted using a federated, real-time national database. A total of 15,267,921 children without GSIs and 6261 children with GSIs between 2017 and 2023 were identified. The study evaluated the incidence and annual proportions of GSIs among different demographics. In addition, the incidence proportions per 100,000 for accidental, nonaccidental, fracture-related, and fatal GSIs were analyzed.

Results: The incidence proportions per 100,000 for GSIs, accidental GSIs, nonaccidental GSIs, fatal GSIs, wheelchair-bound cases, and fracture-related GSIs increased significantly from 2017 to 2023, going from 9.7 to 22.8 (Relative Risk: 2.342, 95% CI: 2.041, 2.687 , P < 0.001). The overall increase was mostly a result of accidental GSI when compared with nonaccidental (incidence proportion 25.8 vs 2.1; P < 0.001) in 2021 at the height of the pandemic. In patients with an accidental GSI, the incidence proportion per 100k between 2017 and 2023 increased from 8.81 to 21.11 (Relative Risk: 2.397, 95% CI: 2.076, 2.768, P < 0.001).

Conclusion: The study supports the shift in the leading cause of death among children from motor vehicle accidents to GSIs, with the continued rise in rates despite the coronavirus disease 2019 pandemic. Accidental injuries constituted the majority of GSIs, indicating the need for enhanced gun safety measures, including requirements for gun storage, keeping firearms locked and unloaded, requiring child supervision in homes with guns, and enforcing stricter punishments as penalties. Comprehensive efforts are required to address this public health crisis. Pediatricians play a vital role in counseling and educating families on firearm safety.

Level of evidence: Level III.

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来源期刊
CiteScore
3.30
自引率
17.60%
发文量
512
审稿时长
6 months
期刊介绍: ​Journal of Pediatric Orthopaedics is a leading journal that focuses specifically on traumatic injuries to give you hands-on on coverage of a fast-growing field. You''ll get articles that cover everything from the nature of injury to the effects of new drug therapies; everything from recommendations for more effective surgical approaches to the latest laboratory findings.
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