FIREARM INJURY AMONG URBAN YOUTH DURING THE LAST DECADE - AN ESCALATION IN VIOLENCE

Purpose: To better characterize firearm violence in urban youth, the a uthors investigated the circumstances and outcome of shootings among y ouths under 17 years of age. Methods: A retrospective case review was undertaken of all patients under 17 years of age treated for a gunshot wound at two adjoining level 1 Trauma Centers (adult and pediatric) a dministering to a predominantly lower socioeconomic population from Ja nuary 1986 to December 1995. Demographics, injury severity, circumstan ces, and outcome of injury were analyzed. Results: 323 youths were wou nded by firearms. The mean age was 12.8 years, and 82.3% were boys. Th ere was a 110% increase in frequency of wounding noted during the seco nd half of study (219 v 104), predominantly in the adolescent subset ( 160% increase for age greater than 12 years v 30% increase for age 12 years and under). The mean injury severity score and trauma score were 9.3 and 14.4, respectively. Violent circumstances (assault, crossfire , drive-by shooting, suicide) accounted for 60.4% of injuries and more than doubled over the study period (26.7% of total in the first 2 yea rs [n = 4], 68.8% in the last 2 years [n = 55]). Unintentional injurie s (self nonsuicide, family, friend) accounted for 26.3% of the injurie s and declined in relative frequency over the study period (46.7% of t otal in the first 2 years [n = 7], 20.0% in the last 2 years [n = 16]) . Black boys had the highest wounding incidence (9.2/1,000 population) , were most commonly injured by assault (29.0%), and had a higher mean number of wounds (1.8). White boys had a lower wounding incidence (3. 1/1,000 population), were more often injured unintentionally by a frie nd (41.2%), and had a lower mean number of wounds (1.3), none as a res ult of violence. Girls had a wounding incidence of less than 2/1,000 a nd were most commonly injured in crossfire (40.7%). Ten percent of sho otings were fatal. The assailant was known to the victim in 52.8% of c hildren less than 6 years of age, but only 24.7% of children over 12 y ears of age. Conclusions: The incidence of gunshot wounds in the youth of this urban population has increased substantially over the past de cade. Adolescent black boys were the most frequent victims of these sh ootings. There has been a disproportionate growth in violent circumsta nces surrounding the shootings. Copyright (C) 1997 by W.B. Saunders Co mpany.