Maternal and Child Health Journal

, Volume 20, Issue 5, pp 1082–1090 | Cite as

Racial/Ethnic Specific Trends in Pediatric Firearm-Related Hospitalizations in the United States, 1998–2011

  • Bindu Kalesan
  • Stefan Dabic
  • Sowmya Vasan
  • Steven Stylianos
  • Sandro Galea


Objectives To determine the temporal patterns and the difference in trends by race/ethnicity of pediatric firearm hospitalizations (FH) among those aged 15 years or younger in the United States. Methods Data on pediatric FH was retrieved from the Nationwide Inpatient Sample between 1998 and 2011 (n = 16,998,470) using external cause of injury codes (E-codes) of the International Classification of Diseases, Ninth Revision, Clinical modification, (assault: E9650-E9654, unintentional: E9220-E9224, E9228, and E9229, suicide: E9550-E9554, E9556, and E9559, undetermined: E9850-E9854, and E9856 and legal: E970). Meta-regression was used to determine the significance of temporal trends. Survey logistic regression adjusted for survey year was used to examine association of pediatric FH with social and demographic characteristics. Results An annual reduction of 1.07 per 100,000 hospitalizations (p-trend = 0.011) was observed between 1998 and 2011. There was reduction in rate of unintentional-FH (p-trend = 0.013), suicide-FH (p-trend = 0.029), and undetermined-FH (p-trend = 0.002), but not assault-FH (p-trend = 0.18). A decline in rates of FH was observed among whites (p-trend = 0.021) and Hispanics (p-trend = 0.03) while an increase in rates of assault-FH was observed among black children. All other intents and all other racial/ethnic groups showed declining rates during this interval. Conclusions There was an overall decline in rates of pediatric FHs in this time period driven by a decline in unintentional-FHs. However there was an increase in assault FH among black children during this same time period.


Firearm injury Temporal trends Injury severity Hospitalization Pediatric 



Firearm hospitalization


Financial Disclosure

Bindu Kalesan was employed by PPD from 08/2014 to 08/2015 and reports no financial relationships relevant to this article. Sandro Galea, Sowmya Vasan, Steven Stylianos and Stefan Dabic has no financial relationships relevant to this article to disclose.

Compliance with Ethical Standard

Conflict of interest

The authors have no conflicts of interest relevant to this research to disclose.


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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Bindu Kalesan
    • 1
    • 2
    • 3
  • Stefan Dabic
    • 3
  • Sowmya Vasan
    • 3
  • Steven Stylianos
    • 4
  • Sandro Galea
    • 5
  1. 1.Center for Clinical Translational Epidemiology and Comparative Effectiveness Research, Department of MedicineBoston University School of MedicineBostonUSA
  2. 2.Gun Violence Survivors FoundationPhiladelphiaUSA
  3. 3.Department of Epidemiology, Mailman School of Public HealthColumbia UniversityNew YorkUSA
  4. 4.Department of SurgeryColumbia University Medical CenterNew YorkUSA
  5. 5.Boston University School of Public HealthBostonUSA

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