Gunshot wounds require more surgery, have a higher mortality rate and cost more per patient than any other childhood injury.

That’s according to a new study by Oregon Health & Science University and UC Davis researchers published online by the journal Pediatrics.

“While children with gunshot wounds made up only 1 percent of the sample, they accounted for more than 20 percent of deaths following injury and a disproportionate share of hospital costs,” said study co-author Nathan Kuppermann, chair of emergency medicine at the UC Davis Medical Center, in a news release.

Children injured by gunshot had the highest proportion of: serious injuries (23 percent), major surgery (32 percent), in-hospital deaths (8 percent) and per-patient costs ($28,000 per patient) when compared to a list of other ways of being hurt that included falls, car crashes or being hit by a car, stabbed or struck by a blunt object.

The researchers reviewed data from about 50,000 injured children and teenagers, ages 19 and under, over a three-year period in the Sacramento; Santa Clara; Portland, Ore.; Vancouver, Wash.; King County, Washington; and Denver.

Being shot ranked second only to motor vehicles as a cause of death for Americans ages 1-19, when taken as a group, during the first decade of this century, according to Garen Wintemute, who joined UCD colleague James Holmes among the study’s other co-authors.

Curbing gunshot injuries will require broad-based interdisciplinary efforts, including research partnerships with national organizations and evidence-based legislation, the researchers conclude.

“There has been little science and lots of misinformation cited on the topic of gunshot injuries in children,” said Craig Newgard, study leader and director of the Center for Policy and Research in Emergency Medicine at OHSU, in a news release. “This study was intended to add some objective data to the conversation.”

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