Sivarajasingam Vaseekaran, Page Nicholas, Morgan Peter, Matthews Kent, Moore Simon, Shepherd Jonathan
Violence and Society Research Group, School of Dentistry, Cardiff University, Heath Park, Cardiff CF14 4XY, United Kingdom.
Violence and Society Research Group, School of Dentistry, Cardiff University, Heath Park, Cardiff CF14 4XY, United Kingdom.
Injury. 2014 Mar;45(3):592-8. doi: 10.1016/j.injury.2013.06.020. Epub 2013 Jul 16.
Injury records from Emergency Departments (EDs) have been studied over the last decade as part of the work of the National Violence Surveillance Network (NVSN) and provide information about local, regional and national violence levels and trends in England and Wales. The purpose of the current study is to evaluate overall, gender, age-specific and regional trends in community violence in England and Wales from an ED perspective from January 2005 to December 2009.
Violence-related injury data were collected prospectively in a stratified sample of 77 EDs (Types 1, 3 and 4) in the nine Government Office Regions in England and in Wales. All 77 EDs were recruited on the basis that they had implemented and continued to comply with the provisions of the 1998 Data Protection Act and Caldicott guidance. Attendance date, age and gender of patients who reported injury in violence were identified using assault-related attendance codes, specified at the local level. Time series statistical methods were used to detect both regional and national trends.
In total 221,673 (163,384 males: 74%) violence-related attendances were identified. Overall estimated annual injury rate was 6.5 per 1000 resident population (males 9.8 and females 3.4 per 1000). Violence affecting males and females decreased significantly in England and Wales over the 5-year period, with an overall estimated annual decrease of 3% (95% CI: 1.8-4.1%, p<0.05). Attendances decreased significantly for both genders across four out of the five age groups studied. Attendances were found to be highest during the months of May and July and lowest in February. Substantial differences in violence-related ED attendances were identified at the regional level.
From this ED perspective overall violence in England and Wales decreased over the period 2005-2009 but increased in East Midlands, London and South West regions. Since 2006, overall trends according to Crime Survey for England and Wales (CSEW), police and ED measures were similar, though CSEW and ED measures reflect far greater numbers of violent incidents than police data. Causes of decreases in violence in regions need to be identified and shared with regions where violence increased.
在过去十年里，作为国家暴力监测网络（NVSN）工作的一部分，对急诊科（ED）的伤害记录进行了研究，这些记录提供了有关英格兰和威尔士地方、区域及全国暴力水平和趋势的信息。本研究的目的是从急诊科的角度评估2005年1月至2009年12月期间英格兰和威尔士社区暴力的总体、性别、年龄特异性及区域趋势。
前瞻性收集了英格兰和威尔士九个政府办公区域内77家急诊科（1、3和4类）分层样本中的暴力相关伤害数据。所有77家急诊科的入选依据是它们已实施并持续遵守1998年《数据保护法》和考尔迪科特指南的规定。通过当地指定的与袭击相关的就诊代码，确定报告暴力伤害患者的就诊日期、年龄和性别。采用时间序列统计方法来检测区域和全国趋势。
共识别出221,673例（163,384例男性：74%）与暴力相关的就诊病例。总体估计年伤害率为每1000名常住人口6.5例（男性每1000名9.8例，女性每1000名3.4例）。在5年期间，英格兰和威尔士影响男性和女性的暴力事件显著减少，总体估计年减少率为3%（95%置信区间：1.8 - 4.1%，p<0.05）。在所研究的五个年龄组中的四个组中，两性的就诊人数均显著减少。发现就诊人数在5月和7月最高，2月最低。在区域层面发现了与暴力相关的急诊科就诊情况存在显著差异。
从急诊科的角度来看，2005 - 2009年期间英格兰和威尔士的总体暴力事件有所减少，但在东米德兰兹、伦敦和西南地区有所增加。自2006年以来，根据英格兰和威尔士犯罪调查（CSEW）、警方和急诊科的衡量标准得出的总体趋势相似，不过CSEW和急诊科的衡量标准所反映的暴力事件数量比警方数据多得多。需要确定暴力事件减少地区的原因，并与暴力事件增加的地区分享。
