Frances Turcotte Benedict1, Siraj Amanullah, James G Linakis, Megan Ranney. 1. From the *Section of Pediatric Emergency Medicine, Department of Emergency Medicine, Alpert Medical School of Brown University; †Injury Prevention Center, Rhode Island Hospital; ‡Department of Pediatrics, and §Department of Emergency Medicine, Alpert Medical School of Brown University, Providence, RI.
Abstract
OBJECTIVE: Assault is a common cause of youth emergency department (ED) visits. Little is known about prior ED utilization patterns among assault-injured youth. This study's objectives were to determine whether, and how, prior ED visit history distinguishes assault-injured youth from unintentionally injured youth. METHODS: A 5-year retrospective, case-control study was conducted using a hospital billing database. Youth ages 13 to 24 years presenting to the ED of an urban level 1 trauma center in 2011 with an E-code of physical assault- or weapon-related injuries were compared 1:1 to randomly assigned, age- and sex-matched controls with an E-code corresponding to unintentional injury. Bivariate, t test, Wilcoxon rank sum tests, and conditional logistic regression were performed to determine how previous ED visits distinguished assault-injured youth from unintentionally injured youth. RESULTS: In 2011, 964 patients presented with assault-related injuries. Over the previous 5 years, assault-injured youth had a median of 1 prior ED visit (interquartile range, 0-3); unintentionally injured youth had a median of zero prior ED visits (interquartile range, 0-2). Assault-injured youth had significantly higher median numbers of previous psychiatric and assault-related ED visits when compared to unintentionally injured youth. A youth with 1 previous psychiatric ED visit had a 4-fold increased odds (adjusted odds ratio [AOR], 4.05; 95% confidence interval, 2.41-6.83) of having a 2011 assault-related ED visit compared to unintentionally injured youth. CONCLUSIONS: Assault-injured youth are more likely to have had prior ED use particularly for psychiatric illnesses and assault-related injury. Targeted youth violence screening may be appropriate for such patients.
OBJECTIVE: Assault is a common cause of youth emergency department (ED) visits. Little is known about prior ED utilization patterns among assault-injured youth. This study's objectives were to determine whether, and how, prior ED visit history distinguishes assault-injured youth from unintentionally injured youth. METHODS: A 5-year retrospective, case-control study was conducted using a hospital billing database. Youth ages 13 to 24 years presenting to the ED of an urban level 1 trauma center in 2011 with an E-code of physical assault- or weapon-related injuries were compared 1:1 to randomly assigned, age- and sex-matched controls with an E-code corresponding to unintentional injury. Bivariate, t test, Wilcoxon rank sum tests, and conditional logistic regression were performed to determine how previous ED visits distinguished assault-injured youth from unintentionally injured youth. RESULTS: In 2011, 964 patients presented with assault-related injuries. Over the previous 5 years, assault-injured youth had a median of 1 prior ED visit (interquartile range, 0-3); unintentionally injured youth had a median of zero prior ED visits (interquartile range, 0-2). Assault-injured youth had significantly higher median numbers of previous psychiatric and assault-related ED visits when compared to unintentionally injured youth. A youth with 1 previous psychiatric ED visit had a 4-fold increased odds (adjusted odds ratio [AOR], 4.05; 95% confidence interval, 2.41-6.83) of having a 2011 assault-related ED visit compared to unintentionally injured youth. CONCLUSIONS: Assault-injured youth are more likely to have had prior ED use particularly for psychiatric illnesses and assault-related injury. Targeted youth violence screening may be appropriate for such patients.
Authors: Rebecca M Cunningham; Stephen T Chermack; Marc A Zimmerman; Jean T Shope; C Raymond Bingham; Frederic C Blow; Maureen A Walton Journal: Pediatrics Date: 2012-05-21 Impact factor: 7.124
Authors: Maureen A Walton; Stephen T Chermack; Jean T Shope; C Raymond Bingham; Marc A Zimmerman; Frederic C Blow; Rebecca M Cunningham Journal: JAMA Date: 2010-08-04 Impact factor: 56.272
Authors: Rebecca Cunningham; Maureen Walton; Matthew Trowbridge; Jim Weber; Ryan Outman; Andy Benway; Ronald Maio Journal: J Pediatr Date: 2006-12 Impact factor: 4.406
Authors: Rebecca M Cunningham; Steven L Bernstein; Maureen Walton; Kerry Broderick; Federico E Vaca; Robert Woolard; Edward Bernstein; Fred Blow; Gail D'Onofrio Journal: Acad Emerg Med Date: 2009-11 Impact factor: 3.451
Authors: Megan L Ranney; John V Patena; Shira Dunsiger; Anthony Spirito; Rebecca M Cunningham; Edward Boyer; Nicole R Nugent Journal: Contemp Clin Trials Date: 2019-05-23 Impact factor: 2.226