Comparing Firearm and Stabbing Injuries in the Pediatric Trauma Population Using Propensity Matching.

Autor:	Lumbard DC; From the Department of Surgery, Hennepin Healthcare., Marek AP; From the Department of Surgery, Hennepin Healthcare., Roetker NS; Chronic Disease Research Group, Hennepin Healthcare Research Institute, Minneapolis, MN., Richardson CJ; From the Department of Surgery, Hennepin Healthcare., Nygaard RM; From the Department of Surgery, Hennepin Healthcare.
Jazyk:	angličtina
Zdroj:	Pediatric emergency care [Pediatr Emerg Care] 2022 Apr 01; Vol. 38 (4), pp. 147-152.
DOI:	10.1097/PEC.0000000000002584
Abstrakt:	Objectives: The objective of this study was to compare differences in mortality and nonhome discharge in pediatric patients with firearm and stab injuries, while minimizing bias. Our secondary objective was to assess the influence of insurance on these same outcomes. Methods: Patients aged 0 to 17 years included in the National Trauma Data Bank (2007-2015) with firearm and stabbing injury were matched by propensity score. Logistic regression was used to assess associations of injury type and insurance with long-term care discharge and death. Results: The average age was 14.8 years, 19.2% were female, 48% were African American, 58.4% had an injury severity score ≤8, and assaults accounted for 73.1% of cases. Firearm injuries were associated with a higher risk of discharge to long-term care (adjusted odds ratio [aOR], 2.07) compared with propensity-matched patients who were stabbed. Similarly, we found a higher risk of mortality in those with firearm injuries compared with stabbing injuries (aOR, 1.85). Regardless of mechanism, self-pay insurance status was associated with a higher risk of mortality (aOR, 2.41). When compared with stab wound patients with commercial insurance, self-pay firearm-injured patients were found to have an increased risk of mortality (aOR, 5.25). Conclusions: Pediatric victims of firearm violence were more likely to die or need additional care outside the home than victims of other types of penetrating injury when accounting for confounding characteristics to minimize bias. Competing Interests: Disclosure: The Hitchcock Surgical Society Resident Research Fund provided funds to purchase the National Trauma Databank. The authors report no conflicts of interest. (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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