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This retrospective cross-sectional analysis queried the Tennessee Chief Medical Examiner database for 643 death certificates of children aged 17 or younger with confirmed firearm-related causes between 2012 and 2022, including demographics, residential data, and autopsy injury 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was the study’s main objective regarding pediatric firearm deaths in Tennessee?","Question",{"text":63,"@type":64},"To investigate mortality indicators among pediatric decedents referred to the Tennessee Chief Medical Examiner with a confirmed firearm-related cause of death.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"Which data sources and methods were used in the study?",{"text":68,"@type":64},"The study queried the Tennessee CME database for death certificates (ages 17 and younger) from 2012 to 2022, reviewed autopsy reports for injury patterns, geocoded neighborhoods using the Child Opportunity Index, and applied statistical tests and regression modeling.",{"name":70,"@type":61,"acceptedAnswer":71},"What trends did the study find over time for homicide and suicide?",{"text":72,"@type":64},"Both homicide and suicide firearm deaths increased significantly over time, with the highest burden concentrated among ages 15 to 17 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To view, please visit the journal online ([https://doi](https://doi). org/10.1136/tsaco-2025- 001908) .  \n1Meharry Medical College School of Medicine, Nashville, Tennessee, USA  \n2Tennessee Department of Health, Office of the State Chief Medical Examiner, Nashville, Tennessee, USA  \n3Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA  \n4Department of Pediatric Surgery, Monroe Carell Junior Children’s Hospital at Vanderbilt, Nashville, Tennessee, USA 5Department of Political Determinants of Health, Meharry Medical College School of Global Health, Nashville, Tennessee, USA  \n6Department of Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee, USA  \nCorrespondence to  \nDr Anthony W Strode; [astrode21@mmc.edu](astrode21@mmc.edu)  \nReceived 2 May 2025 Accepted 8 December 2025  \n© Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.  \nTo cite: Strode AW, Golladay M, Zhao S, et al. Trauma SurgAcute Care Open 2025;10:e001908 .  \nOriginal research  \nFirearm-related deaths in Tennessee children  \nAnthony W Strode  , 1 Molly Golladay  ,2 Shilin Zhao  ,3 Yasmeen Z Qwaider,4 Adele Lewis,2 Rosemary K Nabaweesi  ,5,6 Harold N \"Bo” Lovvorn4  \nABSTRACT  \nBackground The healthcare burden and fatality rate associated with pediatric firearm injuries is increasing substantially. Most published studies evaluating outcomes and disparities of pediatric firearm-related injuries have focused primarily on hospital-level data.  \nThis study aimed to investigate mortality indicators among pediatric decedents referred to the Tennessee Chief Medical Examiner (CME) having a confirmed firearm-related cause of death.  \nMethods In this retrospective cross-sectional study, the Tennessee CME database was queried to reveal 643 death certificates of children ages 17 years and younger who died from a firearm-related injury between 2012 and 2022. Death certificates were surveyed for demographics and residential data. Autopsy reports were reviewed for anatomic injury patterns. The neighborhood of residence for each decedent was geocoded for analysis using the Child Opportunity Index (COI) .  \nPearson, Kruskal-Wallis, Wilcoxon, and linear regression modeling were completed.  \nResults Significant increases in both homicide (n=369; p\u003C0.0001) and suicide (n=202; p=0.001) were documented over time. Firearm deaths increased with age (median age, 16.0 years; IQR (13–17)), with ≥70% of homicide and suicide cases occurring between ages 15 years and 17 years. 272 homicide decedents (76%) were black, and 165 (82%) suicides were white (p\u003C0 .001) . Over half of decedents sustained a head wound (p\u003C0 .001) . Geocoded density maps indicated a correlation between pediatric population race density and predominating manners of firearm death. Residences with a lower COI level were associated with a higher risk of homicide.  \nConclusion In this query of the Tennessee CME registry, homicide rates increased and remained higher than all other firearm manners of death impacting children. This study revealed opportunities to affect meaningful change regarding different ages and manners of lethal firearm injuries among children.  \nLevel of evidence III  \nINTRODUCTION  \nIn 2020, firearm injuries surpassed motor vehicle collisions (MVCs) to become the leading cause of death in children aged 1–17 years in the United States.1–7 Pediatric firearm-related injuries continue to result in discernible healthcare burdens that encompass medical cost, chronic or permanent disability, rehabilitation, mental health, and other societal impacts.8 9 In attempts to mitigate the avoidable strain on healthcare resources, demographic disparities, incidence trends, and the high fatality rates associated with pediatric firearm injuries have  \nWHAT IS ALREADY KNOWN ON THIS TOPIC  \n\n| ⇒ Firearm","cbCaihrSPaU1BED3","https://ap.wps.com/l/cbCaihrSPaU1BED3","pdf",3703504,"English","# Abstract\n## Background\n## Methods\n## Results\n## Conclusion\n# Introduction\n# What Is Already Known on This Topic\n# What This Study Adds\n# How This Study Might Affect Research, Practice, or Policy","[{\"question\":\"What was the study’s main objective regarding pediatric firearm deaths in Tennessee?\",\"answer\":\"To investigate mortality indicators among pediatric decedents referred to the Tennessee Chief Medical Examiner with a confirmed firearm-related cause of death.\"},{\"question\":\"Which data sources and methods were used in the study?\",\"answer\":\"The study queried the Tennessee CME database for death certificates (ages 17 and younger) from 2012 to 2022, reviewed autopsy reports for injury patterns, geocoded neighborhoods using the Child Opportunity Index, and applied statistical tests and regression modeling.\"},{\"question\":\"What trends did the study find over time for homicide and suicide?\",\"answer\":\"Both homicide and suicide firearm deaths increased significantly over time, with the highest burden concentrated among ages 15 to 17 years.\"}]","Firearm-related deaths in Tennessee children - Original research - Abstract | PDF",1790671330,23]