Cunningham Rebecca M, Walton Maureen A, Roahen Harrison Stephanie, Resko Stella M, Stanley Rachel, Zimmerman Marc, Bingham C Raymond, Shope Jean T
Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan, USA.
J Emerg Med. 2011 Oct;41(4):418-26. doi: 10.1016/j.jemermed.2009.11.024. Epub 2010 Feb 10.
An inner-city emergency department (ED) visit provides an opportunity for contact with high-risk adolescents to promote injury prevention.
To identify the prevalence of injuries sustained over the past year by teens presenting to an inner-city ED, and to identify factors associated with recent injury to inform future ED-based injury prevention initiatives.
Over 1 year, 7 days a week, from 1:00-11:00 p.m., patients aged 14-18 years presenting to the ED participated in a survey regarding past-year risk behaviors and injuries.
Of the entire group of teens presenting to the ED (n = 1128) who completed the survey (83.8% response rate), 46% were male, and 58% were African-American. Past-year injuries were reported by 768 (68.1%) of the teens; 475 (61.8%) of those reported an unintentional injury and 293 (38.1%) reported an intentional injury. One-third of all youth seeking care reported a past-year sports-related injury (34.5%) or an injury related to driving or riding in a car (12.3%), and 8.2% reported a gun-related injury. Logistic regression found that binge drinking (adjusted odds ratio [AOR] 1.95) and illicit weapon carrying (AOR 2.31) predicted a past-year intentional injury. African-American youth (AOR 0.56) and those receiving public assistance (AOR 0.73) were less likely to report past-year unintentional injuries.
Adolescents seeking care in an inner-city ED, regardless of the reason for seeking care, report an elevated prevalence of recent injury, including violence. Future injury screening and prevention efforts should consider universal screening of all youth seeking ED care.
在内城区急诊科就诊为接触高危青少年以促进伤害预防提供了契机。
确定过去一年中到内城区急诊科就诊的青少年所受伤害的发生率，并确定与近期伤害相关的因素，为未来基于急诊科的伤害预防举措提供参考。
在一年多的时间里，每周7天，晚上1点至11点，到急诊科就诊的14至18岁患者参与了一项关于过去一年风险行为和伤害的调查。
在到急诊科就诊并完成调查的青少年（n = 1128）中，83.8%为有效回复率，其中46%为男性，58%为非裔美国人。768名（68.1%）青少年报告过去一年受过伤；其中475名（61.8%）报告为意外伤害，293名（38.1%）报告为故意伤害。所有寻求治疗的青少年中，三分之一报告过去一年有与运动相关的伤害（34.5%）或与驾驶或乘车相关的伤害（12.3%），8.2%报告有与枪支相关的伤害。逻辑回归分析发现，酗酒（调整优势比[AOR]为1.95）和非法携带武器（AOR为2.31）可预测过去一年的故意伤害。非裔美国青少年（AOR为0.56）和接受公共援助的青少年（AOR为0.73）报告过去一年意外伤害的可能性较小。
在内城区急诊科寻求治疗的青少年，无论就诊原因如何，报告近期伤害（包括暴力）的发生率都较高。未来的伤害筛查和预防工作应考虑对所有到急诊科就诊的青少年进行普遍筛查。
