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

J Spinal Cord Med. 2023 Jan;46(1):68-74. doi: 10.1080/10790268.2021.1943250. Epub 2021 Jul 7.


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; Gun injury; Quality of life; Spinal cord injury.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Child
  • Cohort Studies
  • Humans
  • Quality of Life
  • Retrospective Studies
  • Risk Factors
  • Spinal Cord Injuries* / complications
  • Spinal Cord Injuries* / etiology

Grants and funding

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