Adult outcomes for children who sustained firearm-related spinal cord injuries

Abstract

Objective:

To describe the adult functional, participation, education, employment, and quality of life outcomes of children who incurred spinal cord injury (SCI) as the result of gun injuries vs. non-violent etiologies, as well as their utilization of health services.

Design:

Retrospective-cohort study. Eligibility criteria were current age at least 18 years, at least 5 years after SCI, and injury prior to 19 years of age. After enrolling the gun injury group, we matched individuals with non-violent etiologies from the Midwest Regional SCI Model System database to the gun injury group’s demographic characteristics. Adult outcomes included education level, employment, income, involvement with the criminal justice system, quality of life indicators using PROMIS and SCI-QOL item banks, and utilization of health services.

Participants:

Twenty-six participants with gun injury SCI matched with 19 participants with non-violent etiologies.

Results:

Average age at injury was 15 years and current age was 44 years for both cohorts. Individuals from racial minority groups were over-represented in the gun injury cohort. The gun-injury cohort had lower educational attainment. Though employment rates were similar, the gun injury group had a lower income level. Both groups endorsed high average levels of function and quality of life on the PROMIS and SCI-QOL short forms.

Conclusions:

SCI etiology reflects racial characteristics of the sample and is associated with subsequent educational attainment and income. Rehabilitation planning should consider gun injury etiology in children not as a characteristic that determines a poor outcome, but as a risk factor for reduced educational attainment and lifetime income.

Keywords:

• Firearm
• Spinal cord injury
• Quality of life
• Gun injury

Acknowledgements

Alison Peipert was instrumental in the completion of this study through study coordination and participant recruitment. Patrick Semick provided statistical analysis of all data.

Disclaimer statements

Contributors Dr Gaebler and Dr Heinemann conceptualized and designed the study, drafted the manuscript and reviewed and revised the manuscript. Dr Pruente conceptualized and designed the study, coordinated and supervised data collection, drafted the initial manuscript and reviewed and revised the manuscript. Dr Zebracki and Dr Mukherjee helped to conceptualize and design the study and reviewed the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Conflict of interest Dr Deborah Gaebler Spira is a consultant for RehabTek. The remaining authors have no financial relationships relevant to this article to disclose. There are no conflicts of interest.

Data archiving

The supporting data is not available due to IRB restrictions with regard to data sharing.

Additional information

Funding

The Craig H. Neilsen Foundation funded this project through an infrastructure grant to the Shirley Ryan AbilityLab.