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Characteristics of youth seeking emergency care for assault injuries.

ABSTRACT: To characterize youth seeking care for assault injuries, the context of violence, and previous emergency department (ED) service utilization to inform ED-based injury prevention.A consecutive sample of youth (14-24) presenting to an urban ED with an assault injury completed a survey of partner violence, gun/knife victimization, gang membership, and context of the fight.A total of 925 youth entered the ED with an assault injury; 718 completed the survey (15.4% refused); 730 comparison youth were sampled. The fights leading to the ED visit occurred at home (37.6%) or on streets (30.4%), and were commonly with a known person (68.3%). Fights were caused by issues of territory (23.3%) and retaliation (8.9%); 20.8% of youth reported substance use before the fight. The assault-injured group reported more peer/partner violence and more gun experiences. Assault-injured youth reported higher past ED utilization for assault (odds ratio [OR]: 2.16) or mental health reasons (OR: 7.98). Regression analysis found the assault-injured youth had more frequent weapon use (OR: 1.25) and substance misuse (OR: 1.41).Assault-injured youth seeking ED care report higher levels of previous violence, weapon experience, and substance use compared with a comparison group seeking care for other complaints. Almost 10% of assault-injured youth had another fight-related ED visit in the previous year, and ~5% had an ED visit for mental health. Most fights were with people known to them and for well-defined reasons, and were therefore likely preventable. The ED is a critical time to interact with youth to prevent future morbidity.

SUBMITTER: Cunningham RM

PROVIDER: S-EPMC3876183 | biostudies-literature | 2014 Jan

REPOSITORIES: biostudies-literature

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Characteristics of youth seeking emergency care for assault injuries.

Cunningham Rebecca M RM Ranney Megan M Newton Manya M Woodhull Whitney W Zimmerman Marc M Walton Maureen A MA

Pediatrics 20131209 1

<h4>Objective</h4>To characterize youth seeking care for assault injuries, the context of violence, and previous emergency department (ED) service utilization to inform ED-based injury prevention.<h4>Methods</h4>A consecutive sample of youth (14-24) presenting to an urban ED with an assault injury completed a survey of partner violence, gun/knife victimization, gang membership, and context of the fight.<h4>Results</h4>A total of 925 youth entered the ED with an assault injury; 718 completed the ...[more]

PMID: 24323994

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Project description:INTRODUCTION:Violence is a leading cause of morbidity and mortality for youth, with more than 600,000 emergency department visits annually for assault-related injuries. Risk for criminal justice involvement among this population is poorly understood. The objective of this study was to characterize arrests among high-risk, assault-injured, drug-using youth following emergency department treatment. METHODS:Youth (aged 18-24 years) with past 6-month drug use who were seeking emergency department treatment for either an assault or for non-violence reasons were enrolled (December 2009-September 2011) in a 2-year longitudinal study. Arrests in the 24 months following the emergency department visit were analyzed in 2016-2017 using survival analysis of objective Law Enforcement Information Network data. Hazard ratios quantifying the association between risk factors for arrest were estimated using Cox regression. RESULTS:In the longitudinal cohort, 511 youth seeking emergency department care (assault injury group n=299, comparison group n=212) were aged ?18 years and were included for analysis. Youth in the assault injury group cohort had a 47% higher risk of arrest than the comparison group (38.1% vs 25.9%, RR=1.47, p<0.05). In unadjusted analyses, male sex, assault injury, binge drinking, drug use disorder, and community violence exposure were all associated with increased risk of arrest during the follow-up period. Cox regression identified that male sex (hazard ratio=2.57), drug use disorder diagnosis (hazard ratio=1.42), assault injury at baseline (hazard ratio=1.63), and community violence exposure (hazard ratio=1.35) increased risk for arrest. CONCLUSIONS:Drug-using assault-injured youth have high rates of arrest. Emergency department and community interventions addressing substance use and violence involvement may aid in decreasing negative violence and criminal justice outcomes among high-risk youth. TRIAL REGISTRATION:This study is registered at www.clinicaltrials.gov NCT01152970.

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Characteristics of youth seeking emergency care for assault injuries.

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Characteristics of youth seeking emergency care for assault injuries.

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