In harm's way: Unintentional firearm injuries in young children.

PURPOSE:Firearm-related trauma represents a major source of preventable injury and death. Many firearm injuries in young children are unintentional, and the true incidence may be underestimated. We sought to characterize the morbidity of unintentional firearm injuries. METHODS:National Trauma Data Bank data from 2007 to 2014 was obtained for patients aged 0-14 sustaining gunshot wounds (GSW). We analyzed demographics, injury severity score, hospital and ICU length of stay (LOS), ventilator days, discharge to rehab, and mortality. We categorized intention as assault, unintentional, self-inflicted or other, and compared unintentional firearm injuries against all others using Student's t test or chi-square analysis. RESULTS:We identified 7487 GSW patients aged 0-14, of whom 2514 (33.6%) sustained unintentional injuries. The mortality rate for unintentionally injured patients was 9.2%, compared with 14.2% for all other intentions (p<0.0001). Unintentionally injured children were more likely to be male (p=0.01) and Caucasian (p<0.0001) and had lower rates of ICU admission (p=0.02), ventilator use (p=0.0004), and discharge to rehab (p<0.0001). CONCLUSIONS:Unintentional injuries comprise one-third of firearm injuries and approximately 10% of GSW-related mortality in young children. Since these injuries are entirely preventable, our findings suggest a major opportunity to reduce disease burden. LEVEL OF EVIDENCE:IV.