422 - Trends in Pediatric Penetrating Injury: A 10-Year Analysis of Emergency Department Visits across a New York State Health System (2014-2024)

Olivia Frank, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York City, NY, United States; Emma Cornell, Northwell Health Center for Gun Violence Prevention, Lake Success, NY, United States; Chethan Sathya, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, new hyde park, NY, United States

Background: Penetrating injuries including intentional and unintentional gunshot and stab wounds, are leading drivers of pediatric morbidity and mortality in the United States. Patients with these injuries face higher risk for reinjury and hospital readmission, among other mental and physical health consequences. Understanding the burden of penetrating injury, including trends in geographic and demographic distribution among pediatric patients is thus essential to guide allocation of prevention and intervention resources to appropriately reflect differing regional needs.

Objective: We conducted a retrospective analysis of 10 years of emergency department (ED) visits to identify trends in pediatric penetrating injury.

Design/Methods: We analyzed electronic medical records for ED visits across 16 health system hospitals from January 2014 to November 2024, to identify patients ≤18 years with ICD-10-CM discharge diagnoses for penetrating injury inflicted by a firearm, knife, or unclassified sharp object, excluding injuries caused by glass. Patient zip code was used to identify city and county of residence. Median household income was matched by zip code to the 2022 U.S Census Bureau’s American Community Survey data. Counties with ≤6 injuries in the analysis period were excluded. Descriptive analyses were conducted using SPSS.

Results: From January 1, 2014 to November 1, 2024, 3760 pediatric patients presented to EDs with penetrating injuries caused by a firearm, knife, or other unspecified object, averaging 342 injuries per year (range: 100-578). Most patients injured were male (59%), Caucasian/White (48%), not Hispanic (73%), and ages 15-18 (40%). Less than 15% of discharge diagnosis indicated intent, with 8% (n=309) coded as intentional self-injuries, 4% (n=146) as accidents, and 3% (n=95) as assaults. Nearly half (44%) of injured patients resided in Richmond County (Staten Island), followed by Suffolk County (29%) and Queens County (9%). Patients were most likely to live in zip codes with a median household income between $80,000-109,999 (37%), followed by $110,000-139,999 (25%).

Conclusion(s): In the past 10 years, penetrating injuries have resulted in a large volume of ED visits across the health system, a disproportionate percentage of which have occurred among young male patients in Richmond County and Suffolk County. It is important to further elucidate drivers of specific forms of penetrating injury to develop effective, relevant prevention and intervention resources. This data also demonstrates the need to understand geographic distribution of injuries, to highlight communities facing disproportionate burdens.