2 Divisions of Pediatric Emergency Medicine Department of Pediatrics, Çukurova University Faculty of Medicine, Adana
3 Divisions of Pediatric Emergency Medicine, Department of Pediatrics, Tepecik Education and Research Hospital, İzmir
4 Division of Pediatric Intensive Care, Department of Pediatrics, Sağlık Bilimleri University, Gazi Yasargil Training and Research Hospital, Diyarbakır
5 Department of Pediatrics, Adıyaman University Faculty of Medicine, Adıyaman
6 Division of Pediatric Intensive Care, Department of Pediatrics, Antalya University Faculty of Medicine, Antalya
7 Division of Pediatric Intensive Care, Department of Pediatrics, Afyon University Faculty of Medicine, Afyon
8 Division of Pediatric Emergency Medicine, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara
9 Department of Pediatrics, Mersin University Faculty of Medicine, Mersin
10 Division of Pediatric Intensive Care, Mersin City Hospital, Mersin
11 Division of Pediatric Intensive Care
12 Division of Pediatric Emergency Medicine, Department of Pediatrics, Gazi University Faculty of Medicine, Ankara
13 Department of Pediatrics, Çanakkale Onsekiz Mart University Faculty of Medicine, Çanakkale
14 Division of Pediatric Intensive Care, Department of Pediatrics, Ege University Faculty of Medicine, İzmir
15 Division of Pediatric Intensive Care, Department of Pediatrics, Ondokuz Mayıs University Faculty of Medicine, Samsun
16 Divisions of Pediatric Intensive Care, Department of Pediatrics, Çukurova University Faculty of Medicine, Adana
17 Department of Pediatrics, Trakya University Faculty of Medicine, Edirne, Türkiye
18 Social Pediatrics and Department of Pediatrics, Ankara University Faculty of Medicine, Ankara
19 Pediatric Intensive Care, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara DOI : 10.24953/turkjped.2021.4564 Background. A significant number of children are injured by or die from firearm-related incidents every year, although there is a lack of global data on the number of children admitted to pediatric emergency departments (PEDs) and pediatric intensive care units (PICU) with firearm injuries. This study is the most comprehensive analysis of firearm injuries sustained by children in Turkey to date.
Methods. This multicenter, retrospective, cohort study was conducted between 2010 and 2020 with the contributions of the PEDs, PICUs, intensive care units, and surgery departments of university hospitals and research hospitals.
Results. A total of 508 children were admitted to hospital with firearm-related injuries in the research period, although the medical records of only 489 could be obtained. Of the total admissions to hospitals, 55.0% were identified as unintentional, 8.2% as homicide, 4.5% as self-harm, and 32.3% as undetermined. The Glasgow Coma Scale (GCS) and ventilation support were found to be the most significant predictors of mortality, while head/neck injury, length of stay (LOS) in the hospital and surgical interventions were found to be the most significant predictors of disability. The overall mortality of firearm-related injuries was 6.3%, and the mortality for children admitted to the PICU was 19.8%. The probability of disability was calculated as 96.0% for children hospitalized with firearm injuries for longer than 75 days.
Conclusions. Head/neck injury, LOS in the hospital, and surgical interventions were found to be the most significant parameters for the prediction of disability. Hospitalization exceeding 6 days was found to be related to disability.
Keywords : firearm injuries, disability, mortality, pediatric emergency medicine, pediatric intensive care