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Severity of Kids' Gun Injuries Getting Worse: Study

By Amy Norton
HealthDay Reporter

TUESDAY, April 23 (HealthDay News) -- Children and teenagers who suffer gunshot wounds are much more likely to die than kids who have other types of serious injuries, a study at two Colorado hospitals shows.

Researchers found that of nearly 7,000 kids treated at two Denver-area trauma centers, those injured by a gun were 10 times more likely to die than those injured in other ways -- such as a car crash or a fall.

What's more, kids' firearm injuries got increasingly more severe over the course of the eight-year study, the investigators reported in the April 24 issue of the Journal of the American Medical Association.

It's not clear why. One possibility is that the guns themselves are "getting worse," speculated lead researcher Dr. Angela Sauaia, an associate professor of public health, medicine and surgery at the University of Colorado, Denver.

But there's also the fact that emergency care for gunshot victims has improved in recent years, Sauaia said, so there may be more kids with severe wounds surviving long enough to make it to the hospital.

One expert offered a more fundamental perspective.

"The question that the [study] really begs is, 'Why are children as young as 4 being injured and killed by guns at all?'" said Dr. Eric Fleegler, of Boston Children's Hospital.

In recent research, Fleegler said he found that U.S. states with more gun control laws tended to have fewer gun deaths, particularly suicides.

"Out of 28 possible firearm laws, Colorado has just five, putting it near the middle of the United States," Fleegler noted. He added that, overall, Colorado's firearm death rate is slightly higher than the national average -- 10.3 per 100,000 people, vs. 9.9 per 100,000 for the entire United States.

The issue of gun violence and gun control was thrown into the spotlight once again last December, when 26 people -- including 20 children -- were killed in the Sandy Hook Elementary School shooting in Newton, Conn.

Congress responded by crafting a bipartisan compromise that would have expanded background checks for gun buyers. But just last week, the U.S. Senate rejected the measure.

This latest study looked at nearly 7,000 kids between the ages of 4 and 17 who were treated at trauma centers in Denver and Aurora between 2000 and 2008. The study period did not include victims from the 2012 mass shooting at an Aurora movie theater that left a dozen dead and dozens more injured.

Overall, 129 children and teens were treated for firearm injuries, and 13 percent of them died. That compared to just less than 2 percent of kids who had suffered other types of injuries.

On average, the severity of kids' gun injuries rose from a nine on a standard scale in 2000 to a 15 by 2008. According to Sauaia, that translates to a twofold increase in the risk of death.

There was not enough reliable information to know the precise circumstances of each shooting, Sauaia said, but 14 percent of the gun injuries were determined to be self-inflicted.

"What we do know in those cases," Sauaia said, "is that a minor had access to a loaded, unlocked gun. I think we can all agree that's not a good thing."

Another expert agreed.

"Pediatric gun injury is a tremendous public health problem, and is largely preventable with measures most Americans support," said Dr. Beth Ebel, a pediatrician at Seattle Children's Hospital.

She said some "proven" safety measures include locking up guns -- unloaded and with the ammunition locked away separately -- and universal background checks for gun sales.

Fleegler said laws focused on child safety are key.

"Legislation aimed at improving child safety around firearms -- including childproofing handguns with special trigger locks, storing guns unloaded or inaccessible, and prohibiting juvenile handgun purchases -- would be a significant step forward in reducing pediatric gun fatalities," he said.

Since the study involved only two Denver-area hospitals, it is not clear whether the findings reflect a national norm, Sauaia said. She said studies in other areas of the country would be helpful -- particularly if researchers can get detailed information on the nature of kids' gun injuries.

More information

The Injury-Free Coalition for Kids has information on gun safety.

SOURCES: Angela Sauaia, M.D., Ph.D., associate professor, public health, medicine and surgery, University of Colorado, Denver; Eric Fleegler, M.D., M.P.H., pediatric emergency medicine, Boston Children's Hospital; Beth Ebel, M.D., M.P.H., associate professor, pediatrics, University of Washington and Seattle Children's Hospital; April 24, 2013, Journal of the American Medical Association

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