The effect of gun control laws on hospital admissions for children in the United States
BACKGROUND Gun control laws vary greatly between states within the United States. We hypothesized that states with strict gun laws have lower mortality and resource utilization rates from pediatric firearms related injury admissions. METHODS Kids' Inpatient Database (1997 2012) was searched for accidental (E922) self inflicted (E955) assault (E965) legal intervention related (E970) or undetermined circumstance (E985) firearm injuries. Patients were younger than 20 years and admitted for their injuries. Case incidence trends were examined for the study period. Propensity score matched analyses were performed using 38 covariates to compare outcomes between states with strict or lenient gun control laws. RESULTS Overall, 38,424 cases were identified, with an overall mortality of 7% Firearm injuries were most commonly assault (64% followed by accidental (25% undetermined circumstance (7% or self inflicted (3% A small minority involved military grade weapons (0.2% Most cases occurred in lenient gun control states (48% followed by strict (47% and neutral (6% On 1:1 propensity score matched analysis, in hospital mortality by case was higher in lenient (7.5% versus strict (6.5% states, p 0.013. Lenient states had a proportionally higher rate of accidental (31% and self inflicted injury (4% versus strict states (17% and 1.6% respectively) p 0.001. Assault related injuries were proportionally lower in lenient (54% versus strict (75% states, p 0.001. Military grade weapons were more common in lenient (0.4% versus strict (0.1% states, p 0.001. CONCLUSIONS These findings highlight the importance of legislative measures and their role in injury prevention, as firearm injuries are entirely avoidable mechanisms of injury. Lenient gun control contributes not only to worse outcomes per case, but also to a more significant and detrimental impact on public health. LEVEL OF EVIDENCE Epidemiologic study, level III.
The journal of trauma and acute care surgery