During the study period, the ED had 519,218 patient visits, including over 110,000 trauma victims (including major and minor trauma). During the study period, a total of 16,597 ED patients met major trauma criteria upon arrival, 2,191 (13%) of which were of age 0-18.

The mechanisms of injury in these 2,191 pediatric major trauma victims are shown in Table 2 and Figure 1. The expected rise in falls at age 1, children hit by cars at age 6, and MVCs in the teenage years were all seen. cialis canadian pharmacy

Figure 1. Major Trauma Incidence by Age and Type

Of the 2,191 major trauma victims age birth—18, 688 (31%) had been shot and 276 (13%) had been stabbed, for a total of 964 (44% of pediatric major traumas) who had been the victim of a major shooting or stabbing.

Penetrating injury was the predominant etiology of major trauma in children after the 14th birthday (56%) but only accounted for 7% of the major injuries in younger children. Of the 964 major gunshot wound and stabbing cases aged birth—18 years, 926 (96%) were between the ages of 14 and 18. GSW victims 0-18 years old averaged 16.583 years of age; SW victims 0-18 years old averaged 16.534 years of age.
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Table 2. Age and Type of Injury 1992-1999

The number of major gunshot wounds of children aged 14 was greater than for all younger age groups combined, and the incidence of these injuries continued to rise sharply through age 18. This pattern was seen both in the summary data for the study period and in each of the eight years reviewed. Nearly twice the number of serious stab-bings occurred in the one year after a child’s 14th birthday than in all younger age groups combined. As with major gunshot wounds, the incidence of major stabbing then continued to rise sharply each year through age 18. This did not change over time during the eight-year study period. This pattern was seen both in the overall data and in each of the eight years reviewed. erectalis 20

The ANOVA procedure was run for the gunshot wound and stabbing trauma data for ages 13 through 15. ANOVA determined that the age of the patient displayed a significant trend (F-value 11.5, df=2) such that as the child got older, his/her risk of being a victim of a major gunshot wound or stabbing increased. On the other hand, the year in which the incident occurred was judged random (F-value 1.36, df=7), meaning that the fluctuation in numbers between calendar years during the study period saw no significant pattern. That validated the use of the nonparametric Kruskal-Wallis tests performed on GSW and SW data separately. The Kruskal-Wallis tests found that the number of major gunshot and stabbing cases significantly increased in the year after the 14th birthday (alpha=0.0026 for GSW; alpha=0.0099 for SW). That was the first statistically significant increase (p<0.05) shown in the data. Although the number of GSW and SW start to rise before the 14th birthday, 14 is the age at which the increase in GSW and SW first exhibit a statistically significant increase.