• Zoe M Miller, Benjamin P Cooper, Daphne Lew, Rachel M Ancona, Vicki Moran, Christopher Behr, Marguerite W Spruce, Lindsay M Kranker, Michael A Mancini, Matt Vogel, Doug J E Schuerer, Lindsay Clukies, Megan L Ranney, Randi E Foraker, and Kristen L Mueller.
• Brown School of Social Work, Washington University in St. Louis, St. Louis, Missouri (Z.M.M.).
• Ann. Intern. Med. 2024 Oct 1; 177 (10): 138113881381-1388.

BackgroundFirearm injuries are the leading cause of death among children aged 0 to 17 years in the United States.ObjectiveTo examine the factors associated with recurrent firearm injury among children who presented with acute (index) nonfatal firearm injury in the St. Louis region.DesignMulticenter, observational, cohort study.Setting2 adult and 2 pediatric level I trauma hospitals in St. Louis, Missouri.ParticipantsPediatric patients aged 0 to 17 years presenting with an index firearm injury between 2010 and 2019.MeasurementsFrom the St. Louis Region-Wide Hospital-Based Violence Intervention Program Data Repository, we collected data on firearm-injured patient demographics, hospital and diagnostic information, health insurance status, and mortality. The Social Vulnerability Index was used to characterize the social vulnerability of the census tracts of patients' residences. Analysis included descriptive statistics and time-to-event analyses estimating the cumulative incidence of experiencing a recurrent firearm injury.ResultsDuring the 10-year study period, 1340 children presented with an index firearm injury. Most patients were Black (87%), non-Hispanic (99%), male (84%), and between the ages of 15 and 17 years (67%). The estimated risk for firearm reinjury was 6% at 1 year and 14% at 5 years after initial injury. Male children and those seen at an adult hospital were at increased risk for reinjury.LimitationOur data set does not account for injuries occurring outside of the study period and for reinjuries presenting to nonstudy hospitals.ConclusionChildren who experience an initial firearm injury are at high risk for experiencing a recurrent firearm injury. Interventions are needed to reduce reinjury and address inequities in the demographic and clinical profiles within this cohort of children.Primary Funding SourceNational Institutes of Health.

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