Violent Injury as a Predictor of Subsequent Assault-Related Emergency Department Visits Among Adolescents

Authors

Marci J. Fornari, Children's National Hospital, Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia. Electronic address: MFornari@childrensnational.org.
Gia M. Badolato, Children's National Hospital, Division of Emergency Medicine, Washington, District of Columbia.
Krithika Rao, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia.
Monika K. Goyal, Children's National Hospital, Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia.
Robert McCarter, Children's National Hospital, Division of Translational Science, George Washington University School of Medicine and Health Sciences (retired), Washington, District of Columbia.
Katie A. Donnelly, Children's National Hospital, Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia.

Document Type

Journal Article

Publication Date

2-1-2023

Journal

The Journal of adolescent health : official publication of the Society for Adolescent Medicine

DOI

10.1016/j.jadohealth.2022.12.014

Keywords

Adolescent violence; Assault injury; Hospital-based violence intervention program; Recidivism

Abstract

PURPOSE: To measure the risk of a subsequent assault-related emergency department (ED) visit in assault injured adolescents as compared to those who initially presented for non-assault related injuries. METHODS: This was a historical cohort study of youth (ages 10-18 years) seen at two pediatric EDs between 2016 and 2019. Participants were included if their visit had an International Classification of Diseases-10 code for assaultive injury or accidental injury (motor vehicle collisions (MVC) and sports injuries). We calculated the rate of a subsequent ED visit for an assault-related injury, and then used survival analysis to compare time to subsequent ED visit with an assault-related injury between study and comparison groups. RESULTS: A total of 6125 adolescents met inclusion criteria (Assault: n = 2782, 45.4%; MVC: n = 1834, 29.9%; Sports n = 1509, 24.6%). The overall rate per 100 person years of a subsequent assault-related ED visit was 5.6 (n = 344). Patients who initially presented with an assault-related injury had an increased adjusted relative risk (aRR) of return for a subsequent ED visit for an assault-related injury when compared to MVC patients (aRR 17.6 [95% CI: 9.6, 32.2]). Kaplan-Meier time to event analysis found that patients in the assault injury group have a higher probability of a subsequent ED visit for an assault-related injury compared to patients in the MVC injury group (adjusted hazard ratio (aHR): 17.7 [95% CI: 9.67, 32.42]). CONCLUSIONS: Adolescents injured by assault are more likely to return to the ED for a subsequent assault-related injury compared to adolescents who initially present with non-assault-related injuries.

APA Citation

Fornari, Marci J.; Badolato, Gia M.; Rao, Krithika; Goyal, Monika K.; McCarter, Robert; and Donnelly, Katie A., "Violent Injury as a Predictor of Subsequent Assault-Related Emergency Department Visits Among Adolescents" (2023). GW Authored Works. Paper 2465.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/2465

Department

Pediatrics