Suchergebnisse

BACKGROUND: This study aimed to evaluate the patterns of firearm violence against children before and after the COVID-19 pandemic, as well as the patterns of specific types of firearm violence against children over time (2016-2020). METHODS: Retrospective firearm violence data were obtained from the Gun Violence Archive. The rate of firearm violence was weighted per 100,000 children. A scatterplot was created to depict the rate of total annual child-involved shooting incidents over time; with a linear trendline fit to 2016 to 2019 data to show projected versus actual 2020 firearm violence. All 50 states were categorized into either strong gun law (n = 25) or weak gun law (n = 25) cohorts. Multivariate linear regressions were performed for number of child-involved shootings over time. RESULTS: There were a total of 1,076 child-involved shootings in 2020, 811 in 2019, and 803 in 2018. The median total child-involved shooting incidents per month per 100,000 children increased from 2018 to 2020 (0.095 vs. 0.124, p = 0.003) and from 2019 to 2020 (0.097 vs. 0.124, p = 0.010). Child killed by adult incidents also increased in 2020 compared with 2018 (p = 0.024) and 2019 (p = 0.049). The scatterplot demonstrates that total child-involved shootings in addition to both fatal and nonfatal firearm violence incidents exceeded the projected number of incidents extrapolated from 2016 to 2019 data. Multivariate linear regression demonstrated that, compared with weak gun law states, strong gun law states were associated with decreased monthly total child-involved shooting incidents between 2018 and 2020 (p < 0.001), as well as between 2019 and 2020 (p < 0.001). CONCLUSION: Child-involved shooting incidents increased significantly in 2020 surrounding the COVID-19 pandemic. Given that gun law strength was associated with a decreased rate of monthly child-involved firearm violence, public health and legislative efforts should be made to protect this vulnerable population from exposure to firearms. LEVEL OF EVIDENCE: ...

Abstract
Purpose
Domestic violence (DV) during pregnancy is associated with a higher incidence of obstetric complications. This study aimed to identify the injury profile and outcomes of pregnant trauma patients (PTPs) presenting after DV. We hypothesize that PTPs presenting after DV have a higher rate of fetal delivery (FD) and adverse maternal outcomes, compared to propensity-matched PTPs sustaining non-DV trauma.

Methods
PTPs ≥ 18 years old were included in this post-hoc analysis of a multicenter retrospective (2016–2021) study at 12 Level-I/II trauma centers. An unmatched and a 1:2 propensity-matched analyses of PTPs presenting with mechanisms involving and not involving DV were performed.

Results
From 950 patients, 70 (7.4%) PTPs presented after DV. The median age of PTPs presenting after DV was 26 years, the most common ethnicity was Hispanic (40%), and the most common mechanism and injury type were assault (85.7%) and abdominal injury (11.4%). PTPs presenting after DV had a higher rate of head injury (10% vs. 4.2%, p = 0.026). There was no difference in maternal complications and rate of FD (p > 0.05). These results did not change in the 1:2 propensity-matched analysis.

Conclusion
Our study found a higher rate of head injuries among PTPs presenting after DV compared to similarly matched PTPs presenting after non-DV trauma. However, no significant differences were observed in the rate of FD or maternal and fetal complications. Examining the effectiveness of universal screening for DV in the trauma setting and prenatal care may help optimize care delivery and support services for affected PTPs.