Factors associated with assault-related firearm injuries in male adolescents

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.