{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T09:38:09Z","timestamp":1792834689786,"version":"4.5.0"},"reference-count":44,"publisher":"American Academy of Pediatrics (AAP)","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,1]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>We conducted a multicenter observational cohort study of youth aged 15 to 17\u00a0years 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>From 2010 through 2023, there were 1433 youth aged 15 to 17\u00a0years 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\u20138.4) and 22.4% (95% CI 19.8\u201325.4) at 1 and 10\u00a0years, respectively. Youth who were male (HR: 4.4; 95% CI 2.1\u20139.3), Black (HR: 4.0; 95% CI 1.6\u20139.9), and treated at an adult hospital for index injury (HR: 1.5; 95% CI 1.1\u20132.0) had higher risk of reinjury over time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1542\/hpeds.2026-009207","type":"journal-article","created":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T00:03:11Z","timestamp":1783555391000},"page":"e582-e591","source":"Crossref","is-referenced-by-count":0,"title":["The Crisis of Adolescent Firearm Reinjury: A 14-Year Retrospective Cohort Analysis"],"prefix":"10.1542","volume":"16","author":[{"given":"Kristen L.","family":"Mueller","sequence":"first","affiliation":[{"name":"1Department of Emergency Medicine, Washington University in St. Louis School of Medicine, St. Louis, Missouri"},{"name":"2Department of Emergency Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daphne","family":"Lew","sequence":"additional","affiliation":[{"name":"3Center for Biostatistics and Data Science, Washington University in St. Louis School of Medicine, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Szoko","sequence":"additional","affiliation":[{"name":"4Division of Adolescent Medicine, Washington University in St. Louis School of Medicine, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zoe M.","family":"Miller","sequence":"additional","affiliation":[{"name":"5Washington University in St. Louis School of Public Health, St. Louis, Missouri"},{"name":"6Brown School of Social Work, Washington University in St. Louis, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taylor","family":"Kaser","sequence":"additional","affiliation":[{"name":"1Department of Emergency Medicine, Washington University in St. Louis School of Medicine, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin P.","family":"Cooper","sequence":"additional","affiliation":[{"name":"5Washington University in St. Louis School of Public Health, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Behr","sequence":"additional","affiliation":[{"name":"7SSM Saint Louis University Hospital, Saint Louis University School of Medicine, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsay","family":"Clukies","sequence":"additional","affiliation":[{"name":"8Department of Pediatrics, Washington University in St. Louis School of Medicine, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Finney","sequence":"additional","affiliation":[{"name":"8Department of Pediatrics, Washington University in St. Louis School of Medicine, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marguerite W.","family":"Spruce","sequence":"additional","affiliation":[{"name":"9Department of Surgery, Section of Acute and Critical Care Surgery, Washington University in St. Louis School of Medicine, St. Louis, Missouri"},{"name":"10USA C-STARS ETL, U.S. Air Force School of Aerospace Medicine, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsay M.","family":"Kranker","sequence":"additional","affiliation":[{"name":"9Department of Surgery, Section of Acute and Critical Care Surgery, Washington University in St. Louis School of Medicine, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael A.","family":"Mancini","sequence":"additional","affiliation":[{"name":"11Saint Louis University School of Social Work, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Kroll","sequence":"additional","affiliation":[{"name":"1Department of Emergency Medicine, Washington University in St. Louis School of Medicine, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin G.","family":"Dawson","sequence":"additional","affiliation":[{"name":"12Department of Surgery, Division of Trauma, Surgical Critical Care, and Emergency Surgery, University of Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matt","family":"Vogel","sequence":"additional","affiliation":[{"name":"1Department of Emergency Medicine, Washington University in St. Louis School of Medicine, St. Louis, Missouri"},{"name":"13School of Criminal Justice, The State University of New York at Albany, Albany, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel M.","family":"Ancona","sequence":"additional","affiliation":[{"name":"1Department of Emergency Medicine, Washington University in St. Louis School of Medicine, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vicki","family":"Moran","sequence":"additional","affiliation":[{"name":"14Trudy Busch Valentine School of Nursing, Saint Louis University, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melik","family":"Coffey","sequence":"additional","affiliation":[{"name":"4Division of Adolescent Medicine, Washington University in St. Louis School of Medicine, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kateri-Chapman","family":"Kramer","sequence":"additional","affiliation":[{"name":"1Department of Emergency Medicine, Washington University in St. Louis School of Medicine, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doug J. E.","family":"Schuerer","sequence":"additional","affiliation":[{"name":"9Department of Surgery, Section of Acute and Critical Care Surgery, Washington University in St. Louis School of Medicine, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elvin","family":"Geng","sequence":"additional","affiliation":[{"name":"5Washington University in St. Louis School of Public Health, St. Louis, Missouri"},{"name":"15Division of Infectious Diseases, Department of Medicine, Washington University in St. Louis, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan L.","family":"Ranney","sequence":"additional","affiliation":[{"name":"16Yale School of Public Health, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Randi E.","family":"Foraker","sequence":"additional","affiliation":[{"name":"17Department of Biomedical Informatics, Biostatistics and Medical Epidemiology, University of Missouri, Columbia, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2026,7,9]]},"reference":[{"key":"2026102404522304800_r1","article-title":"WISQARS (Web-based Injury Statistics Query and Reporting System)","author":"Centers for Disease Control and Prevention","year":"2025"},{"issue":"11","key":"2026102404522304800_r2","doi-asserted-by":"crossref","first-page":"2212","DOI":"10.1016\/j.jpedsurg.2023.04.020","article-title":"Hospital-based violence intervention programs to reduce firearm injuries in children: a scoping review","volume":"58","author":"Nofi","year":"2023","journal-title":"J Pediatr Surg."},{"issue":"1","key":"2026102404522304800_r3","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1177\/00027162231173324","article-title":"Social and structural determinants of community firearm violence and community trauma","volume":"704","author":"Buggs","year":"2022","journal-title":"Ann Am Acad Pol Soc Sci."},{"issue":"9","key":"2026102404522304800_r4","doi-asserted-by":"crossref","first-page":"1163","DOI":"10.7326\/M23-0069","article-title":"Incidence of and factors associated with recurrent firearm injury among patients presenting to St. Louis trauma centers, 2010 to 2019: a cohort study","volume":"176","author":"Mueller","year":"2023","journal-title":"Ann Intern Med."},{"key":"2026102404522304800_r5","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1016\/j.jss.2024.09.066","article-title":"Pediatric firearm reinjury: a retrospective statewide risk factor analysis","volume":"303","author":"Price","year":"2024","journal-title":"J Surg Res."},{"issue":"5","key":"2026102404522304800_r6","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1111\/acem.13641","article-title":"Multicenter analysis of transport destinations for pediatric prehospital patients","volume":"26","author":"Lerner","year":"2019","journal-title":"Acad Emerg Med."},{"issue":"4","key":"2026102404522304800_r7","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1097\/JTN.0000000000000659","article-title":"What makes a trauma patient \u201cpediatric\u201d? Survey of providers\u2019 admission decision making for pediatric trauma patients","volume":"29","author":"Fakhry","year":"2022","journal-title":"J Trauma Nurs."},{"issue":"2","key":"2026102404522304800_r8","doi-asserted-by":"crossref","first-page":"e49","DOI":"10.1097\/TA.0000000000003627","article-title":"National guideline for the field triage of injured patients: recommendations of the National Expert Panel on Field Triage, 2021","volume":"93","author":"Newgard","year":"2022","journal-title":"J Trauma Acute Care Surg."},{"key":"2026102404522304800_r9","volume-title":"Resources for Optimal Care of the Injured Patient: 2022 Standards","author":"American College of Surgeons Committee on Trauma","year":"2022"},{"issue":"12","key":"2026102404522304800_r10","doi-asserted-by":"crossref","first-page":"e2246429","DOI":"10.1001\/jamanetworkopen.2022.46429","article-title":"Assessment of the accuracy of firearm injury intent coding at 3 US hospitals","volume":"5","author":"Miller","year":"2022","journal-title":"JAMA Netw Open."},{"key":"2026102404522304800_r11","doi-asserted-by":"crossref","first-page":"100683","DOI":"10.1016\/j.conctc.2020.100683","article-title":"Positioning public health surveillance for observational studies and clinical trials: the St. Louis region-wide hospital-based violence intervention program data repository","volume":"21","author":"Mueller","year":"2020","journal-title":"Contemp Clin Trials Commun."},{"issue":"12","key":"2026102404522304800_r12","doi-asserted-by":"crossref","first-page":"1495","DOI":"10.1016\/j.ijsu.2014.07.013","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies","volume":"12","author":"von Elm","year":"2014","journal-title":"Int J Surg."},{"issue":"10","key":"2026102404522304800_r13","doi-asserted-by":"crossref","first-page":"2165","DOI":"10.1093\/jamia\/ocae173","article-title":"Machine learning classification of new firearm injury encounters in the St Louis region: 2010\u20132020","volume":"31","author":"Ancona","year":"2024","journal-title":"J Am Med Inform Assoc."},{"issue":"5","key":"2026102404522304800_r14","doi-asserted-by":"crossref","first-page":"e20174087","DOI":"10.1542\/peds.2017-4087","article-title":"Timing and location of emergency department revisits","volume":"141","author":"Michelson","year":"2018","journal-title":"Pediatrics."},{"issue":"10","key":"2026102404522304800_r15","first-page":"34","article-title":"Measuring community vulnerability to natural and anthropogenic hazards: the Centers for Disease Control and Prevention\u2019s Social Vulnerability Index","volume":"80","author":"Flanagan","year":"2018","journal-title":"J Environ Health."},{"issue":"3","key":"2026102404522304800_r16","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1177\/000313481307900325","article-title":"Injured adolescents, not just large children: difference in care and outcome between adult and pediatric trauma centers","volume":"79","author":"Matsushima","year":"2013","journal-title":"Am Surg."},{"issue":"1","key":"2026102404522304800_r17","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1097\/TA.0000000000000277","article-title":"Teen trauma without the drama: outcomes of adolescents treated at Ohio adult versus pediatric trauma centers","volume":"77","author":"Walther","year":"2014","journal-title":"J Trauma Acute Care Surg."},{"issue":"8","key":"2026102404522304800_r18","doi-asserted-by":"crossref","first-page":"1346","DOI":"10.1016\/j.jpedsurg.2016.03.016","article-title":"Pediatric and adult trauma centers differ in evaluation, treatment, and outcomes for severely injured adolescents","volume":"51","author":"Walther","year":"2016","journal-title":"J Pediatr Surg."},{"issue":"2","key":"2026102404522304800_r19","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1097\/TA.0000000000003407","article-title":"Racial disparities in triage of adolescent patients after bullet injury","volume":"92","author":"Andrade","year":"2022","journal-title":"J Trauma Acute Care Surg."},{"key":"2026102404522304800_r20","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/j.jss.2016.09.040","article-title":"Trauma experts versus pediatric experts: comparison of outcomes in pediatric penetrating injuries","volume":"208","author":"Miyata","year":"2017","journal-title":"J Surg Res."},{"issue":"RR-1","key":"2026102404522304800_r21","first-page":"1","volume":"61","author":"Sasser","year":"2012","journal-title":"MMWR Recomm Rep."},{"issue":"3","key":"2026102404522304800_r22","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1097\/TA.0000000000004245","article-title":"Does destination make a difference? Outcomes after a policy change affecting cutoff times for prehospital transport","volume":"97","author":"Renaud","year":"2024","journal-title":"J Trauma Acute Care Surg."},{"issue":"6","key":"2026102404522304800_r23","first-page":"1345","article-title":"Out-of-hospital decision making and factors influencing the regional distribution of injured patients in a trauma system","volume":"70","author":"Newgard","year":"2011","journal-title":"J Trauma."},{"issue":"5","key":"2026102404522304800_r24","doi-asserted-by":"crossref","first-page":"672","DOI":"10.1080\/10903127.2019.1699211","article-title":"A statewide analysis of EMS\u2019 pediatric transport destination decisions","volume":"24","author":"McManus","year":"2020","journal-title":"Prehosp Emerg Care."},{"key":"2026102404522304800_r25","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1016\/j.ajem.2021.08.047","article-title":"Factors associated with destination of pediatric EMS 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of health as drivers of inequities in pediatric injury","volume":"31","author":"Trinidad","year":"2022","journal-title":"Semin Pediatr Surg."},{"key":"2026102404522304800_r30","first-page":"411","article-title":"Social Vulnerability Index is strongly associated with urban pediatric firearm violence: an analysis of five major US cities","volume-title":"J Trauma Acute Care Surg Sep.","author":"Polcari","year":"2023"},{"key":"2026102404522304800_r31","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/j.puhe.2018.09.029","article-title":"Lack of health insurance among juvenile offenders: a predictor of inappropriate healthcare use and reincarceration?","volume":"166","author":"Baggio","year":"2019","journal-title":"Public Health."},{"issue":"2","key":"2026102404522304800_r32","doi-asserted-by":"crossref","first-page":"e2034208","DOI":"10.1001\/jamanetworkopen.2020.34208","article-title":"Association of firearm access, use, and victimization during adolescence with firearm 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injury: a 2-year prospective cohort study","volume":"169","author":"Cunningham","year":"2015","journal-title":"JAMA Pediatr."},{"issue":"1","key":"2026102404522304800_r43","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1186\/s12888-018-1890-9","article-title":"Prevalence of post-traumatic stress disorder, acute stress disorder and depression following violence related injury treated at the emergency department: a systematic review","volume":"18","author":"Ophuis","year":"2018","journal-title":"BMC Psychiatry."},{"issue":"1","key":"2026102404522304800_r44","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1177\/0886260516669545","article-title":"Post-discharge needs of victims of gun violence in Chicago: a qualitative study","volume":"34","author":"Patton","year":"2019","journal-title":"J Interpers Violence."}],"container-title":["Hospital 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