Purpose: To identify factors associated with an increased prevalence of ass
ault-related firearm injuries in male adolescents.
Methods: This study is a retrospective comparison of two samples of adolesc
ent males from the same geographic localities regarding their involvement i
n the juvenile justice system (court involvement) and injury status (curren
t or prior firearm injury at the time of the study). The subjects included
adolescent male patients admitted to an urban, Level I trauma center for as
sault-related firearm injuries (court-involved and noncourt-involved, n = 6
5); and incarcerated juvenile offenders (prior firearm injury and no known
firearm injury, n 267).
Results: Two-thirds of the male assault-related pediatric firearm injury vi
ctims treated over a two-year period were involved in the juvenile justice
system (court involved). Court-involved adolescents were almost 22 times mo
re likely to have sustained an assault-related firearm injury, when compare
d to noncourt-involved patients with firearm injuries. Additional analysis
documented recent substance use and/or involvement in criminal offenses in
82% of the victims. For most of the juvenile offenders (88%), court involve
ment preceded their injuries. Analysis of the injury patterns revealed an i
ncreased prevalence of truncal injuries (injuries to thorax or abdomen) in
the court-involved victims, when compared to their noncourt-involved peers
(40% and 14% for the court-involved and noncourt-involved samples, respecti
vely; p < .05). Incarceration was associated with a 17-fold increase in the
firearm injury prevalence over the court-involved, but not incarcerated, s
ample.
Conclusions: These results suggest that involvement in substance use and/or
the criminal justice system is associated with an increased risk of firear
m injuries in male adolescents, and that an increased level of involvement
in the juvenile justice system is associated with a concomitant increase in
firearm injuries. (C) Society for Adolescent Medicine, 2000.