From the Division of Emergency Medicine, Department of Medicine (M.C.M., E.W.F., L.K.L.), Boston Children's Hospital, Boston, Massachusetts.
J Trauma Acute Care Surg. 2017 Nov;83(5S Suppl 2):S240-S245. doi: 10.1097/TA.0000000000001525.
Violent-related (assault) injuries are a leading cause of death and disability in the United States. Many violent injury victims seek treatment in the emergency department (ED). Our objectives were to (1) estimate rates of violent-related injuries evaluated in United States EDs, (2) estimate linear trends in ED visits for violent-related injuries from 2000 to 2010, and (3) to determine the associated health care and work-loss costs.
We examined adults 18 years and older from a nationally representative survey (the National Hospital Ambulatory Medical Care Survey) of ED visits, from 2000 to 2010. Violent injury was defined using International Classification of Diseases-9th Rev.-Clinical Modification, diagnosis and mechanism of injury codes. We calculated rates of ED visits for violent injuries. Medical and work-loss costs accrued by these injuries were calculated for 2005, inflation-adjusted to 2011 dollars using the WISQARS Cost of Injury Reports.
An annual average of 1.4 million adults were treated for violent injuries in EDs from 2000 to 2010, comprising 1.6% (95% confidence interval, 1.5%-1.6%) of all US adult ED visits. Young adults (18-25 years), men, nonwhites, uninsured or publically insured patients, and those residing in high poverty urban areas were at increased risk for ED visits for violent injury. The 1-year, inflation-adjusted medical and work-loss cost of violent-inflicted injuries in adults in the United States was US $49.5 billion.
Violent injuries account for over one million ED visits annually among adults, with no change in rates over the past decade. Young black men are at especially increased risk for ED visits for violent injuries. Overall, violent-related injuries resulted in substantial financial and societal costs.
Epidemiological study, level III.
在美国，暴力相关（袭击）伤害是导致死亡和残疾的主要原因。许多暴力伤害受害者在急诊部（ED）接受治疗。我们的目标是：（1）估计在美国 ED 中评估的暴力相关伤害的发生率，（2）估计 2000 年至 2010 年 ED 就诊的暴力相关伤害的线性趋势，（3）确定相关的医疗保健和工作损失成本。
我们从 2000 年至 2010 年的全国代表性调查（国家医院门诊医疗保健调查）中检查了 18 岁及以上的成年人的急诊就诊情况。使用国际疾病分类第 9 修订版-临床修正版、诊断和损伤机制代码来定义暴力伤害。我们计算了 ED 就诊的暴力伤害发生率。使用 WISQARS 伤害成本报告，将这些伤害造成的 2005 年医疗和工作损失成本进行通货膨胀调整，换算为 2011 年的美元。
2000 年至 2010 年期间，每年有平均 140 万成年人在 ED 中接受暴力伤害治疗，占所有美国成年人 ED 就诊的 1.6%（95%置信区间，1.5%-1.6%）。年轻人（18-25 岁）、男性、非白人、无保险或公共保险患者以及居住在高贫困城市地区的人，因 ED 就诊治疗暴力伤害的风险增加。美国成年人因暴力伤害造成的 1 年、通货膨胀调整后的医疗和工作损失成本为 495 亿美元。
暴力伤害每年导致超过 100 万成年人就诊 ED，在过去十年中发病率没有变化。年轻的黑人男性尤其因 ED 就诊治疗暴力伤害的风险增加。总体而言，暴力相关伤害造成了巨大的财务和社会成本。
流行病学研究，三级。
