Past-Year Intentional and Unintentional Injury Among Teens Treated in an Inner-City Emergency Department

Abstract

An inner-city Emergency Department (ED) visit provides an opportunity for contact with highrisk adolescents for promoting injury prevention.Objectives-To identify the prevalence of injuries sustained over the past year by teens presenting to an inner city ED, and to identify factors associated with recent injury to inform future ED-based injury prevention initiatives.Methods-Over one year, seven days a week, from 1:00-11:00 PM, patients ages 14-18 years presenting to the ED participated in a survey regarding past-year risk behaviors and injuries.Results-Of the entire group of teens presenting to the ED (n=1128) who completed the survey (83.8% response rate), 46% were male, and 58% were African-American. Past-year injuries were reported by 768 (68.1%) of the teens; 475 (61.8%) reported an unintentional injury and 293 (38.1%) reported an intentional injury. One-third of all youth seeking care reported a past-year sports-related injury (34.5%) or an injury related to driving or riding in a car (12.3%), and 8.2% reported a gun-related injury. Logistic regression found binge drinking (adjusted odds ratio [AOR]=1.95) and illicit weapon carrying (AOR=2.31) predicted a past-year intentional injury. African American youth (AOR=0.56) and those receiving public assistance (AOR=0.73) were less likely to report past-year unintentional injuries.Conclusions-Adolescents seeking care in an inner city ED, regardless of reason for seeking care, report an elevated prevalence of recent injury including violence. Future injury screening and prevention efforts should consider universal screening of all youth seeking ED care.

Cost−Benefit Analysis Simulation of a Hospital-Based Violence Intervention Program

“…A survey of youth presenting to an emergency department (ED), regardless of chief complaint, found that 9.6% reported sustaining a violent injury resulting in medical treatment in the past year. 48 A similar study of Reinjury healthcare costs þ perpetration victim healthcare costs þ perpetration criminal justice costs þ lost productivity costs Societal adults found that 11.0% reported being assaulted in the past year 49 and a study using Monitoring the Future survey data found a 1-year violent reinjury rate of 8.8% among high school students, 26 but the proportion of injuries resulting in hospital care was not reported in either study. Furthermore, this study focused on violent reinjury at 5-year follow-up and should be considered within the context of research that has assessed violent reinjury at different follow-up periods.…”

The Relationship Between Cumulative Risk and Promotive Factors and Violent Behavior Among Urban Adolescents

“…Although death is the most severe consequence of violence, and homicide is the leading cause of death among African American adolescents (CDC 2009), nonfatal injuries are far more common. In 2007, more than 668,000 10-24 year olds in the United States were treated in emergency departments for injuries caused by violence (CDC 2009) and the ED is increasingly recognized as a important contact location for youth at risk for future violent injury (Cunningham et al 2011). In addition, a recent study surveying all youth presenting to an urban emergency department for any reason found that three quarters of adolescents reported recent peer violence (Walton et al 2009).…”

“…Seven percent of the sample was Hispanic/Latino. This study is based on baseline self-administered survey data collected as part of a randomized control trial (RCT) of an emergency department intervention for alcohol use and violent (aggressive) behaviors (see Cunningham et al and Walton et al for more information) (Cunningham et al 2011;Walton et al 2010). To be selected to complete the baseline survey (and be enrolled in the study), participants had to endorse both past year aggression and alcohol consumption.…”

Improvement in quality of life among violently injured youth after a brief intervention

“…(1)(2)(3)(4)(5)(6)(7)(8)(9) Beyond the physical trauma, violence carries significant lifelong implications for psychosocial development as evidenced by increased psychological and behavioral problems. (3,5,6,10) Obtaining adequate psychosocial, educational, and physical health resources for survivors of violent injury is difficult and many victims return to stressful home environments, making their recovery even more complex.…”