NESS Main Site  |  Past & Future Meetings
New England Surgical Society

Back to 2022 Posters


Safer in School: Changes in Location and Timing of Pediatric Firearm Injuries During COVID-19 School Closures
Aaron Wickard2, Alexander Ordoobadi1, Reza Askari1, Geoffrey Anderson1
1Brigham and Women's Hospital, Boston, Massachusetts, United States, 2Harvard Medical School, Boston, Massachusetts, United States

1. Objective: Gun violence is a leading cause of injury and death in the pediatric population with previous studies demonstrating that most of these injuries occur at home. The COVID-19 pandemic and subsequent school closures created a unique circumstance where children spent an increased time at home. This study identified the changes in the location and timing of pediatric firearm injuries that occurred after school closures to highlight key factors in pediatric gun violence.
2. Design: Retrospective cohort study
3. Setting: General community
4. Patients: Children aged 5-18 involved in firearm injures as determined by ICD-10 codes. Incident timing was determined by dispatch time with incidents labeled as during school hours if the dispatch time was between 0800 - 1500, Monday to Friday, from September to May.
5. Intervention: The pre/post and time series analysis utilized March 2020 as the month of intervention given most school closures occurred during this time.
6. Main Outcome Measures: The hourly frequency of firearm injuries during school hours by month was compared using an interrupted time series. Secondary scene characteristics were compared using the Chi-square test for pre/post intervention analysis.
7. Results: 11,007 firearm injuries were identified in school-aged children over the two-year study period from January 2019 to December 2020. After school closures, the most common location for pediatric gun violence was a private residence (n = 2920, 54.37) followed by the street (n = 1327, 24.71%) regardless of the time of day. School closures resulted in more firearm injuries at home (51.86% vs 54.37%, p = 0.009) and more assaults (53.46% vs 57.44%, p < 0.001). Post-intervention analysis found a significant increase in injuries occurring during school hours after school closures began (0.315 vs 0.402, p = 0.011). The interrupted time series analysis demonstrated no significant increase in the rate of hourly firearm injury frequency in the post-intervention group (95% CI: -0.0085 to 0.0167).
8. Conclusion: Regardless of time of day, private homes remained the most common location for pediatric firearm injury, an unfortunate reality that was exacerbated during school closures. There was an increase in pediatric firearm injuries that occurred during school hours after school closures; however, this is likely attributable to the historical trends in pediatric firearm injuries and not necessarily exacerbated by the COVID-19 pandemic. While this study is limited by relatively little data on post-school closure incidents, the consistent findings regarding the location and timing of pediatric firearm injuries should be a consideration for organizations aimed at preventing firearm injuries in children.


Back to 2022 Posters