Peer-reviewed article
The Crisis of Adolescent Firearm Reinjury: A 14-Year Retrospective Cohort Analysis.
Mueller KL, Lew D, Szoko N, Miller ZM, Kaser T et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study tracked 1,433 adolescents aged 15-17 who survived firearm injuries in St. Louis from 2010 to 2023. One in six survivors experienced another firearm injury during the study period, with the risk reaching 22% by 10 years. Black male adolescents faced the highest risk of reinjury, pointing to the need for targeted violence prevention strategies.
Key points
- Of 1,349 adolescents who survived their initial firearm injury, 233 (17.3%) experienced a reinjury during the 14-year study period
- Estimated reinjury probability was 6.9% at 1 year and 22.4% at 10 years after the initial injury
- Male adolescents had 4.4 times higher risk of reinjury compared to females
- Black adolescents had 4 times higher risk of reinjury compared to other groups
- Youth treated at adult hospitals for their initial injury had 1.5 times higher reinjury risk than those treated at pediatric facilities
Limitations
The study is observational without intervention testing, so it identifies risk factors but cannot determine causation. Findings are specific to the St. Louis region and may not generalise to other US communities or countries.
Abstract
Background Firearm injuries are the leading cause of death among US adolescents. Adolescents are among the highest risk, and those with nonfatal injuries experience high rates of reinjury. Identifying factors that predict firearm reinjury among adolescents may support tailored prevention strategies. This study sought to identify factors associated with firearm reinjury among adolescents who presented with acute nonfatal firearm injury in the St. Louis, Missouri region. Methods We conducted a multicenter observational cohort study of youth aged 15 to 17 years presenting to 2 adult and 2 pediatric trauma centers from 2010 through 2023. We collected data on firearm-injured patient demographics, hospital and diagnostic information, health insurance status, and mortality. Analysis included descriptive statistics, time-to-event analyses estimating reinjury probability, and adjusted hazard ratios (HRs) and 95% CIs. Results From 2010 through 2023, there were 1433 youth aged 15 to 17 years who experienced a firearm injury. Of the 1349 who survived their index injury, 233 (17.3%) experienced a reinjury during the study period. Estimated reinjury probability was 6.9% (95% CI 5.6-8.4) and 22.4% (95% CI 19.8-25.4) at 1 and 10 years, respectively. Youth who were male (HR: 4.4; 95% CI 2.1-9.3), Black (HR: 4.0; 95% CI 1.6-9.9), and treated at an adult hospital for index injury (HR: 1.5; 95% CI 1.1-2.0) had higher risk of reinjury over time. Conclusions Black male adolescents had high risk of firearm reinjury, highlighting the critical need for interventions addressing structural racism and other root causes of community firearm violence.