TRENDS IN ADOLESCENT FIREARM-RELATED INJURY: A TIME SERIES ANALYSIS

Objectives: Firearm-related injury remains a national public health crisis and in 2020, it became the leading cause of death among children and adolescents. As the nature of firearm-related injury varies across the lifespan, investigating them in an age-specific manner provides critical evidence for stakeholders and policy makers. Therefore, this study sought to investigate trends in adolescent firearm-related injury in Atlanta, GA over the last 5 years to identify areas for targeted intervention.

Methods: A city-wide adolescent trauma registry was generated from all Atlanta trauma centers that routinely care for adolescents for January 2016 to June 2021. Adolescents were defined as 11 to 21 years of age and firearm-related injuries were identified based on ICD 9 and 10 codes. Data pertaining to demographics, injury patterns and hospital course was extracted for all firearm-injured individuals. Mechanisms of injury investigated included interpersonal intentional injury, self-inflicted injury, unintentional injury and undetermined. Comparisons were made by year in a time series analysis over a 5-year period.

Results: Over the study period, there were 1,456 adolescents with firearm-related injuries. From 2016 to 2020, the incidence of firearm-related injury among this age demographic increased by 57% and was even higher in the first half of 2021. The overall mortality rate for adolescents of firearm-related injuries was 11.9%. The victims were predominantly Black (86.5%) males (86.8%) with a median age of 18 years [IQR 17-20]. The most common mechanism of injury was interpersonal (74.3%), followed by unintentional discharge of firearms (12.8%), unknown intentionality (9.5%), and self-inflicted injury (2.8%). On Dickey-Fuller testing, the time series for unintentional injuries was found to be non-stationary, and the rate of increase is 7.6/year (p < 0.01).

Conclusion: Firearm-related injury among adolescents remains a public health epidemic and Atlanta, GA is no exception. This study, specifically, demonstrates an alarming increase in the rate of injury secondary to unintentional discharge of firearms among this age demographic. In the context of a pivotal time for firearm policy reform in America, such data serves as critical evidence for stakeholders in terms of where to target key interventions and laws. These results suggest that efforts within the city of Atlanta should focus on safe firearm storage and curbing the incidence of unintentional discharge among youth.