A comparison of female and male adolescent victims of violence seen in the emergency department.

BACKGROUND: Violence is a leading cause of injury and death among adolescents. Reports indicate increasing incidence of violent injuries among adolescent females, but have not described characteristics of or charting completeness for these assault victims in the emergency department (ED).
OBJECTIVES: To compare demographic and injury-related characteristics of assaulted urban adolescent females and males presenting to an ED; and to compare completeness of hospital coding for intentionality of females' and males' injuries.
METHODS: Retrospective, cross-sectional analysis of potentially violent injuries (identified by E-codes and chart review) among urban youth presenting to a city's only level I trauma center. Demographics, injury characteristics, and chart- vs. hospital-determined intentionality were described with proportions and relative risks.
RESULTS: E-code search resulted in 828 charts with injury diagnoses; 385 were determined by chart review to represent violent injuries (150 females, 235 males). Female victims had similar race, age, and socioeconomic status to males. Females' injuries were more likely to be documented as caused by a single person, by someone known to them, and at home. Females were less likely to be injured by weapons or in a public space. Females' charts were more likely to contain information about the circumstances of injury. Intentionality was equally likely to be miscoded for females and males.
CONCLUSIONS: Adolescent female victims of community violence presenting to an urban ED have different assault characteristics from males. Females' charts have less missing information. A high percentage of all charts have assault intentionality miscoded, suggesting that E-code-based violence surveillance in this population may not be accurate.