{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T12:02:15Z","timestamp":1791201735941,"version":"4.2.0"},"reference-count":35,"publisher":"American Academy of Pediatrics (AAP)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,1]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>BACKGROUND\/OBJECTIVES<\/jats:title>\n                    <jats:p>Firearm injuries (FIs) are the leading cause of death for children and adolescents in the United States. Prior studies noted increases in pediatric FI emergency department (ED) visits early in the pandemic, but long-term trends are unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>We conducted a retrospective observational study using the Pediatric Health Information System including patients aged younger than 18 years with an FI-related ED visit from 2016 to 2023. Encounters were identified by International Classification of Diseases, Tenth Revision discharge diagnosis codes for FI. Time series analysis with segmented Poisson regression with hospital-level clustering was used to identify change points and estimate annualized trends in FI encounters (ED visits, hospitalizations, and mortality).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>A total of 6358 pediatric FI ED visits were identified. Most patients were male (79.0%), aged 12 through 17 (69.8%), Black (60.4%), and publicly insured (76%). FI ED visits increased from an average of 44.1 per month in 2016 to 83.3 in 2023. Change points in March and June 2020 marked an early pandemic surge, with ED visits rising at an annualized rate of 496% before before demonstrating no statistically significant linear change thereafter, although volumes remained higher than pre-pandemic levels. Hospitalizations and in-hospital death encounters rose in number, but the proportions remained stable (50.7%-55.5% hospitalized; 5.7%-8.1% mortality).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Pediatric FI ED visits rose early in the COVID-19 pandemic and have remained elevated through 2023, establishing a concerning new baseline. The stable proportions of hospitalizations and in-hospital mortality suggest that increases in absolute counts were driven primarily by rising injury incidence not accompanied by increased severity. Findings underscore the need for sustained prevention and cross-sector collaboration to reduce pediatric FI burden.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1542\/peds.2025-074492","type":"journal-article","created":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T00:03:22Z","timestamp":1789344202000},"source":"Crossref","is-referenced-by-count":1,"title":["Trends in Pediatric Firearm Injuries: 2016\u20132023"],"prefix":"10.1542","volume":"158","author":[{"given":"Geet","family":"Pandya","sequence":"first","affiliation":[{"name":"1Medical College of Wisconsin, Department of Pediatrics, Milwaukee, Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Walsh","sequence":"additional","affiliation":[{"name":"1Medical College of Wisconsin, Department of Pediatrics, Milwaukee, Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Flynn-O\u2019Brien","sequence":"additional","affiliation":[{"name":"1Medical College of Wisconsin, Department of Pediatrics, Milwaukee, Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergey","family":"Tarima","sequence":"additional","affiliation":[{"name":"2University of Kentucky, College of Public Health, Department of Biostatistics, Lexington, Kentucky"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mike","family":"Levas","sequence":"additional","affiliation":[{"name":"1Medical College of Wisconsin, Department of Pediatrics, Milwaukee, Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2026,9,14]]},"reference":[{"issue":"20","key":"2026100507370970800_r1","doi-asserted-by":"crossref","first-page":"1955","DOI":"10.1056\/NEJMc2201761","article-title":"Current causes of death in children and adolescents in the United States","volume":"386","author":"Goldstick","year":"2022","journal-title":"N Engl J Med."},{"issue":"6","key":"2026100507370970800_r2","doi-asserted-by":"crossref","first-page":"e2022060071","DOI":"10.1542\/peds.2022-060071","article-title":"Firearm-related injuries and deaths in children and youth","volume":"150","author":"Lee","year":"2022","journal-title":"Pediatrics."},{"issue":"1","key":"2026100507370970800_r3","doi-asserted-by":"crossref","first-page":"e2020042697","DOI":"10.1542\/peds.2020-042697","article-title":"Firearms injuries involving young children in the united states during the COVID-19 pandemic","volume":"148","author":"Cohen","year":"2021","journal-title":"Pediatrics."},{"issue":"6","key":"2026100507370970800_r4","doi-asserted-by":"crossref","first-page":"e2023063129","DOI":"10.1542\/peds.2023-063129","article-title":"Pediatric FI ED visits from 2017 to 2022: a multicenter study","volume":"152","author":"Hoffmann","year":"2023","journal-title":"Pediatrics."},{"issue":"2","key":"2026100507370970800_r5","doi-asserted-by":"crossref","first-page":"e2021050223","DOI":"10.1542\/peds.2021-050223","article-title":"Pediatric firearm-related hospital encounters during the SARS-CoV-2 pandemic","volume":"148","author":"Gastineau","year":"2021","journal-title":"Pediatrics."},{"issue":"2","key":"2026100507370970800_r6","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1007\/s40653-023-00568-4","article-title":"Call to action: the rise of pediatric gun violence during the COVID-19 pandemic","volume":"17","author":"Schauss","year":"2023","journal-title":"J Child Adolesc Trauma."},{"key":"2026100507370970800_r7","article-title":"Leverage your data with CHA\u2019s Pediatric Health Information System","author":"Children\u2019s Hospital Association","year":"2024"},{"key":"2026100507370970800_r8","article-title":"Violent injury ICD-10 inclusion codes","author":"Illinois Department of Public Health","year":"2022"},{"key":"2026100507370970800_r9","article-title":"How we built it","author":"Noelke","year":"2020"},{"issue":"1","key":"2026100507370970800_r10","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1136\/injuryprev-2020-043872","article-title":"Firearm purchasing and storage during the COVID-19 pandemic","volume":"27","author":"Lyons","year":"2021","journal-title":"Inj Prev."},{"issue":"7","key":"2026100507370970800_r11","doi-asserted-by":"crossref","first-page":"e2518960","DOI":"10.1001\/jamanetworkopen.2025.18960","article-title":"Household firearm storage practices","volume":"8","author":"Conrick","year":"2025","journal-title":"JAMA Netw Open."},{"key":"2026100507370970800_r12","article-title":"How many gun owners are in America? 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