Targeting safety: Exploring trends and risk factors in pediatric head and neck BB gun injuries and hospitalization

Abstract

Objective: To examine head and neck injuries caused by BB (Ball Bearing) guns treated in US emergency departments among children under 18 to identify trends in injury frequency over time and risk factors associated with severe injuries leading to hospital admission.

Methods: This retrospective study utilized data from the National Electronic Injury Surveillance System (NEISS), a single database, to analyze head and neck injuries caused by BB guns between 1993 and 2019. The analysis explored demographic characteristics and injury patterns, including sex, age, incidence, injury location, hospital type, and disposition. Linear regression was employed to assess trends in the yearly frequency of injuries, while univariate and multivariate binary logistic regression was used to calculate the odds ratios associated with hospitalization.

Results: A total of 4041 cases of pediatric head and neck injuries caused by BB guns and treated in US emergency departments were identified. Most patients were male (84 %), with the highest proportion of injuries occurring in the 10-14 age group (49.7 %). The face (35.8 %) and eye (27.4 %) were the most affected injury sites, and 7.5 % of patients required hospital admission. No significant linear trend was observed in injury frequency over the study period. However, children aged four and under had higher odds of hospitalization (OR 2.77, 95 % CI 1.61-4.75) despite a lower incidence of injuries. Injuries to the eye (OR 12.37, 95 % CI 8.31-18.43) and neck (OR 7.58, 95 % CI 4.76-12.06) were strong predictors of hospital admission.

Conclusion: Pediatric BB gun-related head and neck injuries remain a source of emergency room visits nationally. Younger children are at increased risk of admission to the hospital. Eye and neck injuries were the strongest predictors of hospital admission. Implementing safety precautions for younger children is crucial, as injuries might be more severe in this age group.

Keywords: BB guns; Facial trauma; Gunshot wounds; Non-powder firearms; Pediatrics.