Air Guns: A Contemporary Review of Injuries at Six Pediatric Level I Trauma Centers

Background: Studies spanning the last three decades demonstrated the injury causing capability of air gun (AG) projectiles. Recent studies have suggested the impact and incidence of these injuries may be declining because of edcational efforts. We hypothesize that injuries in the pediatric population resulting from AGs remain a significant health concern. Methods: A retrospective review (1/1/2007 to 12/31/2016), of AG-injured children < 19 years old, was performed across six level I Pediatric Trauma Centers, part of the ATOMAC research consortium. AG injuries were defined as injuries sustained by ball-bearing or pellet air-powered guns. Paint ball and soft foam AGs were excluded. Following institutional review board approval, patients were identified by ICD code from the trauma registry. Included were demographic data, injury severity scores, length of stay (LOS), outcome at discharge, and overall cost of admission. Descriptive statistics and parametric tests were employed. Results: A total of 499 patients sustained injuries. Mean age 9.5 (+/- 4.0) y; 81% of victims were male; all survived to hospital discharge. 30% (n = 151) required operative intervention. Hospital LOS was 2.3 (+/- 2.2) d; with mean cost of $23,756 (+/-$34,441). Injury severity score mean of 3.7 (+/- 4.6) on admission. Over 40% of the injuries to the head/thorax that were severe (AIS >= 3) required operative intervention (P < 0.001). Conclusions: AG injuries to the head or thorax seen at trauma centers were likely to require operative management. While no fatalities occurred, the cost was substantial. This study demonstrates pediatric injuries resulting from AG projectiles remain a significant health concern. (C) 2019 Elsevier Inc. All rights reserved.