Snider Carolyn E, Lee Jacques S
Division of Emergency Medicine, University of Toronto, Toronto, Ontario, Canada.
CJEM. 2007 May;9(3):164-9. doi: 10.1017/s1481803500014998.
Concern about youth violence in Canada is growing. Because victims of violence are more likely to become future violent perpetrators, preventative interventions are often based out of inpatient units; however, the question of how often youth who have been injured due to violence are discharged from emergency departments (EDs), or whether there are opportunities for emergency healthcare workers to deliver violence prevention programs, is not known. The primary objectives of this study were to describe the frequency and patterns of violent injuries among youth, to determine how many injured youth are discharged directly from EDs and to estimate the proportion of injured youth who may benefit from ED-based intervention programs.
We conducted an observational study using a population-based database that records information on all ED visits in Ontario. We analyzed age, sex, cause of injury and disposition for all patients aged 12-19 years who presented to Toronto EDs with violent injuries during a 2-year period (April 2002 to March 2004).
A total of 4100 patients aged 12-19 years visited Toronto EDs with violent injuries during the study period. Assault due to bodily force (in contrast to sharp objects, guns or other) was the most common injury mechanism, accounting for 48.7% of cases (95% confidence interval [CI] 47.1%-50.2%). The majority of patients (89.3%; 95% CI 88.3%-90.2%) were discharged directly from EDs, including 44% of gun-related injuries.
In Toronto, a large proportion (89.3%) of youth injured in violent incidents are discharged directly from EDs. There are opportunities to develop ED-based youth violence prevention initiatives.
加拿大对青少年暴力问题的关注度日益增加。由于暴力受害者更有可能成为未来的暴力实施者，预防性干预措施通常基于住院病房开展；然而，因暴力受伤的青少年从急诊科出院的频率如何，或者急诊医护人员是否有机会实施暴力预防项目，目前尚不清楚。本研究的主要目的是描述青少年暴力伤害的频率和模式，确定有多少受伤青少年直接从急诊科出院，并估计可能受益于基于急诊科的干预项目的受伤青少年比例。
我们使用一个基于人群的数据库进行了一项观察性研究，该数据库记录了安大略省所有急诊就诊信息。我们分析了在2年期间（2002年4月至2004年3月）因暴力受伤前往多伦多急诊科就诊的所有12至19岁患者的年龄、性别、受伤原因及处置情况。
在研究期间，共有4100名12至19岁的患者因暴力受伤前往多伦多急诊科就诊。身体暴力攻击（与锐器、枪支或其他情况相比）是最常见的受伤机制，占病例的48.7%（95%置信区间[CI] 47.1%-50.2%）。大多数患者（89.3%；95% CI 88.3%-90.2%）直接从急诊科出院，其中包括44%与枪支相关的受伤患者。
在多伦多，暴力事件中受伤的青少年很大一部分（89.3%）直接从急诊科出院。有机会开展基于急诊科的青少年暴力预防举措。
