Pediatric gunshot wound recidivism: Identification of at-risk youth.

Background: Although penetrating injury is the most common reason for pediatric trauma recidivism, there is a paucity of literature specifically looking at this population. The objective of this study was to identify those in the pediatric community at the highest levels of risk for experiencing gunshot wound (GSW) on multiple occasions.

Methods: A retrospective review querying our urban Level I trauma database was performed. Patients aged 0 year to 18 years sustaining GSW from 2000 to 2011 were selected. This was further refined to include those who returned to the hospital for another firearm injury. Demographic data, including age of initial and subsequent presentation, sex, race, zip code, home address, and disposition were compiled.

Results: During the 12-year study period, 896 pediatric patients were discharged from the hospital after initial firearm injury with subsequent 8.8% recidivism rate. All recidivists were male, and 86% were 16 years to 18 years old at the time of the first injury. The subsequent incident occurs within the first year, 2 years, and 3 years 32%, 53%, and 66% of the time, respectively. Nine individuals in our study group experienced GSW on three separate occasions, with a mortality rate of 22%. Regarding the domicile, 53% of the patients were located in a 3-sq mi area containing four public high schools.

Conclusion: Using demographic data, we have been able to identify an at-risk population where there is a greater than 1 in 12 chance of getting shot multiple times. Use of this type of demographic data can help target those at highest risk by allocating resources that can have the greatest impact on this societal burden.

Level Of Evidence: Prognostic study, level III.