Cheng T L, Wright J L, Fields C B, Brenner R A, O'donnell R, Schwarz D, Scheidt P C
Department of General Pediatrics and Adolescent Medicine, George Washington University School of Medicine and School of Public Health, USA.
Ann Emerg Med. 2001 Mar;37(3):292-300. doi: 10.1067/mem.2001.111763.
Adolescent homicide rates are decreasing nationally for unclear reasons. We explore changes in intentional injury morbidity and mortality within the context of other injuries and specific causes.
We performed surveillance of hospital, medical examiner, and vital records for nonfatal injury among adolescents age 10 to 19 years living in the District of Columbia from June 15, 1996, to June 15, 1998, and fatal injury from 1989 to 1998.
Over the 2-year study period, 15,190 adolescents were seen for injury, resulting in an event-based rate of 148 injuries per 1,000 adolescents per year; 7% required hospitalization, and 0.8% died. Interpersonal intentional injuries accounted for 25% of all injuries, 45% of hospitalizations, and 85% of injury deaths. Assault morbidity decreased with no change noted for unintentional and self-inflicted injury. Firearm injuries, stabs, and assaults with other objects showed the largest decrease, with no decrease in unarmed assaults. Injury mortality peaked in 1993 and has declined since. Firearms caused 72% to 90% of all injury deaths from 1989 to 1998, most the result of homicide.
There has been a decline in intentional injury rates over the study periods related to decreased weapon injury; data suggest a change in the lethality of fighting methods but no change in unarmed fighting behavior.
全国青少年凶杀率正出于不明原因下降。我们在其他伤害及特定原因的背景下，探讨故意伤害的发病率和死亡率变化情况。
我们对1996年6月15日至1998年6月15日居住在哥伦比亚特区的10至19岁青少年的非致命伤害以及1989年至1998年的致命伤害进行了医院、法医及生命记录监测。
在为期两年的研究期间，共诊治了15190例青少年伤害病例，基于事件的发病率为每年每1000名青少年中有148例伤害；7%的患者需要住院治疗，0.8%的患者死亡。人际故意伤害占所有伤害的25%，住院治疗的45%，伤害死亡的85%。攻击伤发病率下降，无意和自残伤害未见变化。火器伤、刺伤及其他物体攻击伤下降幅度最大，徒手攻击伤未见下降。伤害死亡率在1993年达到峰值，此后一直在下降。1989年至1998年，火器导致了所有伤害死亡的72%至90%，大多数是凶杀所致。
在研究期间，与武器伤害减少相关的故意伤害率有所下降；数据表明打架方式的致死性发生了变化，但徒手打架行为没有变化。
