Sotelo-Cruz N, Cordero-Olivares A, Woller-Vázquez R

Language: Spanish
References: 28
Page: 204-210
PDF size: 101.39 Kb.

ABSTRACT

Introduction: During the past 15 years, gunshots wounds in children and adolescents showed a increase woldwide. Risk factor relationships are family, troules, low socioeconomic level, age (adolescence), and ease of acquiring fire arms. We report this retrospective study data conserning gunshot wounds in persons younger than 18 years of age. Material and methods: We reviewed all reports on gunshot wounds and mortality of children and teenagers from Sonora State during 1988 to 1998. We excluded suicides and also reviewed the clinical records of patients with ages between 1 and 18 years of age who were attended at the hospital for gunshot injuries over 20 years. The variable studied age, sex, origin, neigborhood, socioeconomic level, type of action, (accidental or intentional), drug abuse, family troubles, body area injury, treatment, and evolution. Results: In the first place, over the last 10 years the Justice Department of Sonora State has reported 344 cases of gunshot injuries in persons less than 18 years of age; 200 (58.0%) surwived and 144 died (42.9%). In both groups, the injury was intentional in 80% of the cases. In the survivor groups the penetrating wounds were in chest and abdomen. In sixteen and 19%, respective of the patients who died, in only 2.7% was the action accidental. The most important number of gunshot injuries was in adolescents of 16 to 18 years of age and the principal body injury areas were head and chest. In regard to the hospital group we reviewed the clinical records of 58 patients. In this group 84%, were male and a the predominant age group was between 10 to 15 years, the socioeconomic level was low in 79.3%, and three of each 10 patients had poor family integration. Fifty-five percent of patients received the injury on the streets and 50% included conflicts between teenager gang; almost 30% were using drugs at the time. The bodily injury areas in order were legs, abdomen, chest, and bons broken in 12 (20.6%) cases. Penetrating gunshot wounds ocurred in 32.7% of the cases and shock status was 13.7%. Treatment varied to acording wound type and body area. In this paper it is possible show some factors relatives to gunshot wounds, including age, sex, gangs, poor family integration, and low socioconomic level. Throughout mortality by gunshot injuries in some Cities Sonora State has ripen more than in other big cities the world. We need to take action, and to form a collaborative and interdisciplinary group. The objective will be the creasing these important problems, and it is necessary to work and meet with the family, teachers, police, lawyers, the press, legislative officers, heath mental services, social workers and pediatricians.

REFERENCES

1. Ordog GJ. Pediatric gunshot wounds. In Ordog GJ, Management of gusnshot wounds. New York: Elsevier Publishers 1988: 101-126.

2. Wasserberger J, Ordog GJ, Schatz I, Owens D, Prakash A, Balasubramanian S. Gunshot wounds in infant and young children. In: Ordog GJ. Management of gunshot wounds New York: Elsevier Publishers 1988: 127-135.

3. Heins M, Karn R, Bjordhal J. Gunshot wounds in children. Am J Public Health 1974; 64: 326-330.

4. Rivera FP, Stapleton FB. Handguns and children: a dangerous mix. Dev Behav Pediatr 1982; 3: 35-38.

5. Wintemute GJ. Firearms as a cause of death in the United States, 1920-1982. J Trauma 1987; 27: 532-536.

6. Muscat JE. Characteristics of childhood homicide in Ohio 1974-1984. Am J Public Health 1988; 78: 822-824.

7. Barlow B, Niemirsha M, Gandhi RP. Ten years experience wit pediatric gunshot wounds. J Ped Surg 1982; 17: 927-932.

8. Cooper A, Barlow B, Davidson L, Relathford J et al. Epidemiology of pediatric trauma: importance of population based statistics. J Pediatr Surg 1992; 27: 149-154.

9. MMWR 1991; 40: 681-684.

10. Callahan CM, Rivera FP. Urban high school youth and handguns: a school based survery. JAMA 1992; 267: 3038-3042.

11. Arria AM, Wood NP, James CA. Prevalence of carrying a weapon and related behaviors in urban shcoochildren, 1989 to 1993. Arch Pediatr Adolesc Med 1995; 4149: 1345-1350.

12. Durant RH, Getts AG, Caden HC, Woods ER. The association between weapon carrying and the use of violence among adolescents living in or around public housing. J Adolesc 1995; 18: 579-592.

13. INEGI. Cuadernos de estadísticos judiciales. México: 1998; 5: 5-35.

14. Consejo Tutelar de Menores (COTUME). Datos estadísticos de delincuencia en menores. Hermosillo Sonora, México: Gobierno del Estado de Sonora 1998.

15. Prothrow SD. Interdisciplinary interventions applicable to prevention of interpersonal violence and homicide in black youth in the Surgeosn General’s workshop on violence and Public Health. Washington, DC: US Departement of Health and Human Services Publication No. HRS-D-MC86-1 1986: 35-43.

16. Centers for Disease Control: Violent deaths among persons 15-24 years of age-United States, 1970-1978, MMWR 1983; 32: 453-460.

17. Hyar MMC, Tapia JR, Lozano AR, Chávez AR. Violencia y lesiones. Salud Mental 1992; 15: 15-43.

18. Anuario Estadístico del Sistema Estatal de Salud. Daños a la salud en el Estado de Sonora 1993-1997. Five Notebooks, Mexico: Secretaría de Salud Pública, Gobierno del Estado de Sonora 1997.

19. Karasch SJ, Yuknek J, Vinci RJ, Herbert B, Zukerman B. Violence, related injuries in a pediatric emergency department. Pediatr Emerg Care 1997; 13: 95-97.

20. New York State Department of Health Injury control Program: Injury mortality in New York State 1984-1988. Albany, NY, New York State Department of Health 1990.

21. Nance ML, Templeton JM, O’Neill JA. Socieconomic impact of gunshot wounds in an urban pediatric population. J Pediat Sur 1994; 29: 39-43.

22. Mazurek AJ. Penetrating injuries in children: the Chicago perspective. JEUR 1995; 8: 10-13.

23. Ordog GJ. Wound ballistics In: Ordog GJ, Editor Management of gunshot wounds New York: Elsevier Publishers 1988: 25-60.

24. Leonard KA. Firearm deaths in Canadian adolescents and young adults. Can J Public Health 1994; 85: 128-131.

25. West JG. The role of trauma centers in treating victims with gunshot wounds. In: Ordog GJ, editor. Management of gunshot wounds. New York: Elsevier Publishers 1988: 13-23.

26. Reyes Sánchez AQA, Vázquez Caballero R, Almanza A. Fracturas expuestas por proyectil de arma de fuego de baja velocidad. Informe de 25 casos. Rev Mex Ortop Trauma 1990; 4: 121-124.

27. Myers WC, Scott K, Burgess AW, Burgess AG. Psychopathology biopsycosocial factors, crime characteristics, and classification of 25 homicidal youths. J Am Acad Child Adolesc Psychiatry 1995; 34: 1483-1489.

28. Davison LL, Dirkin MS, Kuhn L, O’Connor P, Barlow B, Heagarty MC. The impact of the Safe Kids Healthy Neighborhood Injury Prevention Program in Harlem, 1988 through 1991. Am J Public Health 1994; 84: 580-586.