Risk factors associated with non-fatal adolescent firearm injuries

Study objective: To identify behavioral, environmental, and sociodemographic risk factors associated with non-fatal firearm injuries among inner city adolescents in the United States. Design: A case-control study in which patients with firearm injury serve as cases and those with medical conditions serve as controls. Setting: A level I trauma center in a metropolitan area serving a predominately lower socioeconomic status population. Participants: Cases were 45 consecutive patients 11-18 years presenting to the emergency department with a non-fatal firearm injury; controls were 50 age and gender matched patients presenting with acute medical problems. Outcome measure: Odds ratios (OR) and associated 95% confidence intervals (Cl) as estimates of the magnitude of association between risk factors and non-fatal firearm injury. Results: After adjusting for age, gender and socioeconomic status, multivariate analysis identified four risk factors independently associated with firearm injury: living with less than two parents (OR 3.8, 95% Cl 1.2 to 12.2), skipping class (OR 7.1, 95% Cl 1.7 to 28.9), previous arrest (OR 6.2, 95% Cl 1.9 to 20.7), and being African-American (OR 4.2; 95% Cl 1.4 to 14.9). Conclusion: Risk factors for adolescents sustaining a non-fatal firearm injury are sociodemographic and environmental, not just behavioral. Thus interventions that foster protective and supportive environments may help prevent firearm injuries.