Objective: 

To compare new mental health diagnoses (NMHD) in children after a firearm injury versus following a motor vehicle collision (MVC).

Background: 

A knowledge gap exists regarding childhood mental health diagnoses following firearm injuries, notably in comparison to other forms of traumatic injury.

Methods: 

We utilized Medicaid MarketScan claims (2010–2016) to conduct a matched case-control study of children ages 3 to 17 years. Children with firearm injuries were matched with up to 3 children with MVC injuries. Severity was determined by injury severity score and emergency department disposition. We used multivariable logistic regression to measure the association of acquiring a NMHD diagnosis in the year postinjury after firearm and MVC mechanisms.

Results: 

We matched 1450 children with firearm injuries to 3691 children with MVC injuries. Compared to MVC injuries, children with firearm injuries were more likely to be black, have higher injury severity score, and receive hospital admission from the emergency department (P<0.001). The adjusted odds ratio (aOR) of NMHD diagnosis was 1.55 [95% confidence interval (95% CI): 1.33–1.80] greater after firearm injuries compared to MVC injuries. The odds of a NMHD were higher among children admitted to the hospital compared to those discharged. The increased odds of NMHD after firearm injuries was driven by increases in substance-related and addictive disorders (aOR: 2.08; 95% CI: 1.63–2.64) and trauma and stressor-related disorders (aOR: 2.07; 95% CI: 1.55–2.76).

Conclusions: 

Children were found to have 50% increased odds of having a NMHD in the year following a firearm injury as compared to MVC. Programmatic interventions are needed to address children’s mental health following firearm injuries.

中文翻译：

---

枪支和机动车辆相关伤害后的心理保健：影响我们治疗策略的差异

 客观的：

比较儿童在枪伤后与机动车辆碰撞 (MVC) 后的新心理健康诊断 (NMHD)。

 背景：

关于枪伤后的儿童心理健康诊断存在知识差距，特别是与其他形式的创伤性伤害相比。

 方法：

我们利用 Medicaid MarketScan 索赔（2010-2016 年）对 3 至 17 岁的儿童进行匹配的病例对照研究。枪伤儿童与最多 3 名 MVC 受伤儿童进行匹配。严重程度由伤害严重程度评分和急诊室处置决定。我们使用多变量逻辑回归来衡量在枪械和 MVC 机制受伤后一年内获得 NMHD 诊断的关联。

 结果：

我们将 1450 名遭受枪伤的儿童与 3691 名遭受 MVC 伤害的儿童进行了匹配。与 MVC 伤害相比，枪伤儿童更有可能是黑人，伤害严重程度评分更高，并从急诊科入院 ( P <0.001)。与 MVC 损伤相比，枪械损伤后 NMHD 诊断的调整优势比 (aOR) 高 1.55 [95% 置信区间 (95% CI)：1.33–1.80]。与出院儿童相比，入院儿童患 NMHD 的几率更高。枪伤后发生 NMHD 的几率增加是由于物质相关和成瘾性疾病（aOR：2.08；95% CI：1.63–2.64）以及创伤和压力源相关疾病（aOR：2.07；95% CI：1.55– 2.76）。

 结论：

研究发现，与 MVC 相比，儿童在枪伤后一年内患 NMHD 的几率增加了 50%。需要有计划的干预措施来解决枪伤后儿童的心理健康问题。