Firearm related injuries amongst children: estimates from the nationwide emergency department sample.

OBJECTIVE: The objective of this study is to provide estimates of firearm related injuries in children seeking care in hospital based emergency departments.

METHODS: The Nationwide Emergency Department Sample (NEDS) for the year 2008 was used for the current study. All ED visits occurring amongst children aged less than or equal to 18 years and that had an External Cause of Injury (E-Code) for any of the firearm related injuries were selected for analysis.

RESULTS: A total of 14,831 ED visits (in children) in the United States had a firearm injury. The average age of the ED visits was 15.9 years. Males constituted a predominant proportion of all ED visits (89.2%). A total of 494 patients died in the emergency departments (3.4% of all ED visits) whilst 323 died following in-patient admission into the same hospital (6% of all inpatient admissions). The most frequently documented firearms were assaults by firearms and explosives (55% of all ED visits), accidents caused by firearms and air gun missiles (33.6%), and injuries by firearms that were undetermined (7.4%). The average charge for each ED visit was $3642 (25th percentile is $1146, median is $2003, and 75th percentile is $4404). The mean charge for those visits that resulted in in-patient admission into the same hospital was $70,164 (25th percentile is $16,704, median is $36,111, and 75th percentile is $74,165) and the total charges for the entire United States was about $371.33 million.

CONCLUSIONS: The current study used the largest all-payer hospital based emergency department dataset to provide national estimates of firearm related injuries amongst children in the United States during the year 2008 and highlights the public health impact of such injuries.