Firearm injuries in a pediatric population: African-American adolescents continue to carry the heavy burden

•Firearm injuries due to assault are more likely to occur in African-American adolescent males.•This group requires more extensive care and suffers greater morbidity and mortality.•Case-fatality rate for young adolescent patients is significantly higher than national data, likely due to more severe ISS.

BackgroundFirearm injuries have the highest case-fatality rate among pediatric trauma related deaths. We sought to determine whether demographics, mechanism of injury, and outcomes were age specific.MethodsWe performed a 5 year retrospective analysis of patients 0-19 years old with firearm related injuries. Children were divided into two cohorts based on age. Mann-Whitney and Pearson's X2 were used to compare continuous and categorical variables, respectively. Significance was established at p < 0.05.DataCompared to their younger counterparts, children >15 years old were more likely to be male (82% vs. 90%, p = 0.02), African-American (71% vs 89%, p < 0.0001), and injured due to assault (76.9% vs 44.6%, p < 0.0001). Mortality rates for children <14 was 1.4 times the national average (10.7% vs. 7.5%) while the rate for children >15 was 3.9 times the national average (12.4% vs. 3.2%).ConclusionFirearm injuries continue to be a prevalent public health concern greatly affecting African-American adolescent males. Prevention strategies and trauma related healthcare resource utilization should target this group in order to reduce the risk of injury and improve outcomes and case-fatality in our population.