Borowsky Iris Wagman, Ireland Marjorie
Division of General Pediatrics and Adolescent Health, University of Minnesota, Minneapolis, Minnesota 55455-2002, USA.
Pediatrics. 2004 Mar;113(3 Pt 1):530-6. doi: 10.1542/peds.113.3.530.
Nonfatal fight-related injuries among youths result in lost capacity and high costs of medical care and rehabilitation and constitute a major public health problem. This study identifies factors that predict the occurrence of a fight-related injury that requires medical attention among boys and girls.
We analyzed data from 14 787 adolescents who completing 2 interviews, approximately 1 year apart, in the National Longitudinal Study of Adolescent Health, a nationally representative, school-based sample of youths. We identified time 1 factors at the community, family, and individual levels that predicted any self-reported fight-related injury that required medical treatment at time 2.
Factors that predict future injury among both boys and girls in multivariate models were violence-related factors: witnessing or being a victim of violence (odds ratio [OR]: 3.69; 95% confidence interval [CI]: 1.81-7.49 for boys; OR: 5.13; 95% CI: 1.25-21.09 for girls), history of a violence-related injury (OR: 2.30; 95% CI: 1.60-3.29 for boys; OR: 3.18; 95% CI: 1.87-5.41 for girls), and physical fighting (OR: 2.02; 95% CI: 1.44-2.84 for boys; OR: 5.15; 95% CI: 3.18-8.34 for girls). Among boys, illicit drug use was also an independent predictor of future injury (OR: 1.72; 95% CI: 1.24-2.37), whereas excellent perceived general health (OR: 0.48; 95% CI: 0.25-0.93) and a high grade point average (OR: 0.52; 95% CI: 0.29-0.95) were significant protective factors against fight-related injury. Girls who reported a high level of depressive symptoms were much more likely to report fight-related injury than nondepressed girls (OR: 8.98; 95% CI: 2.43-33.25).
Factors related to violence, substance use, school achievement, and physical and mental health predicted a future fight-related injury that required medical treatment. The results could assist health and social service providers, educators, and others in identifying youths who are at high risk for fight-related injury and may benefit from appropriate intervention.
青少年中与打架相关的非致命伤会导致身体机能丧失以及高昂的医疗和康复费用，构成了一个重大的公共卫生问题。本研究确定了预测男孩和女孩中需要医疗救治的与打架相关伤害发生的因素。
我们分析了来自14787名青少年的数据，这些青少年在全国青少年健康纵向研究中完成了两次访谈，间隔约1年，该研究是一个具有全国代表性的、以学校为基础的青少年样本。我们确定了在社区、家庭和个人层面上的时间1因素，这些因素预测了在时间2时任何自我报告的需要医疗治疗的与打架相关的伤害。
在多变量模型中，预测男孩和女孩未来受伤的因素是与暴力相关的因素：目睹暴力或成为暴力受害者（优势比[OR]：男孩为3.69；95%置信区间[CI]：1.81 - 7.49；女孩为5.13；95% CI：1.25 - 21.09）、与暴力相关的受伤史（OR：男孩为2.30；95% CI：1.60 - 3.29；女孩为3.18；95% CI：1.87 - 5.41）以及肢体冲突（OR：男孩为2.02；95% CI：1.44 - 2.84；女孩为5.15；95% CI：3.18 - 8.34）。在男孩中，非法药物使用也是未来受伤的一个独立预测因素（OR：1.72；95% CI：1.24 - 2.37），而良好的总体健康感知（OR：0.48；95% CI：0.25 - 0.93）和高平均绩点（OR：0.52；95% CI：0.29 - 0.95）是预防与打架相关伤害的显著保护因素。报告有高水平抑郁症状的女孩比无抑郁症状的女孩更有可能报告与打架相关的伤害（OR：8.98；95% CI：2.43 - 33.25）。
与暴力、物质使用、学业成绩以及身心健康相关的因素预测了未来需要医疗治疗的与打架相关的伤害。这些结果可以帮助健康和社会服务提供者、教育工作者及其他人识别出有与打架相关伤害高风险且可能从适当干预中受益的青少年。
