• Wesley E Barry, Erica Barin, Cory M McLaughlin, Aaron Strumwasser, Shant Shekherdimian, Helen Arbogast, Jeffrey S Upperman, and Aaron R Jensen.
• Division of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA; Department of Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA. Electronic address: wesley.barry@med.usc.edu.
• J. Pediatr. Surg. 2019 Feb 1; 54 (2): 350-353.

BackgroundFirearm injuries are now the third leading cause of death in children. Understanding the circumstances surrounding pediatric firearm injuries will allow for targeted injury prevention efforts. We hypothesized that younger children are more likely to be victims of unintentional firearm injury.MethodsA multicenter, retrospective review of patients <18 years old who sustained firearm injuries in Los Angeles County from 2006 to 2015 was performed. Unintentional injuries were defined as accidental firearm discharge without violent intent. Intentional injuries were defined as firearm discharge with intent to injure (including suicide).ResultsAfter review of 304 pediatric firearm injuries, 206 had sufficient narrative to determine intent with 10% of injuries classified as unintentional. Unintentional injuries were more common in younger children, more frequently caused by a firearm from within the home, and more likely to involve friend/family (all p < 0.05). Intentional injuries were associated with more injuries and accounted for all deaths in our study cohort.ConclusionsIn pediatric firearm injury, younger children are more susceptible to unintentional injuries, but intentional injuries are more common overall. Future interventions need to target both intentional violence in older children and unintentional firearm injury in young children if the frequency is to be reduced.Type Of StudyEpidemiologic study.Level Of EvidenceLevel III.Copyright © 2018 Elsevier Inc. All rights reserved.

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