University of Michigan Injury Prevention Center, University of Michigan School of Medicine, Ann Arbor, Michigan; Department of Emergency Medicine, University of Michigan School of Medicine, Ann Arbor, Michigan; Youth Violence Prevention Center, University of Michigan School of Public Health, Ann Arbor, Michigan.
University of Michigan Injury Prevention Center, University of Michigan School of Medicine, Ann Arbor, Michigan; Department of Emergency Medicine, University of Michigan School of Medicine, Ann Arbor, Michigan; Hurley Medical Center, Department of Emergency Medicine, Flint, Michigan.
Am J Prev Med. 2018 Dec;55(6):812-821. doi: 10.1016/j.amepre.2018.07.003. Epub 2018 Oct 19.
Violence is a leading cause of morbidity and mortality for youth, with more than 600,000 emergency department visits annually for assault-related injuries. Risk for criminal justice involvement among this population is poorly understood. The objective of this study was to characterize arrests among high-risk, assault-injured, drug-using youth following emergency department treatment.
Youth (aged 18-24 years) with past 6-month drug use who were seeking emergency department treatment for either an assault or for non-violence reasons were enrolled (December 2009-September 2011) in a 2-year longitudinal study. Arrests in the 24 months following the emergency department visit were analyzed in 2016-2017 using survival analysis of objective Law Enforcement Information Network data. Hazard ratios quantifying the association between risk factors for arrest were estimated using Cox regression.
In the longitudinal cohort, 511 youth seeking emergency department care (assault injury group n=299, comparison group n=212) were aged ≥18 years and were included for analysis. Youth in the assault injury group cohort had a 47% higher risk of arrest than the comparison group (38.1% vs 25.9%, RR=1.47, p<0.05). In unadjusted analyses, male sex, assault injury, binge drinking, drug use disorder, and community violence exposure were all associated with increased risk of arrest during the follow-up period. Cox regression identified that male sex (hazard ratio=2.57), drug use disorder diagnosis (hazard ratio=1.42), assault injury at baseline (hazard ratio=1.63), and community violence exposure (hazard ratio=1.35) increased risk for arrest.
Drug-using assault-injured youth have high rates of arrest. Emergency department and community interventions addressing substance use and violence involvement may aid in decreasing negative violence and criminal justice outcomes among high-risk youth.
This study is registered at www.clinicaltrials.gov NCT01152970.
暴力是导致年轻人发病和死亡的主要原因，每年因袭击相关伤害而前往急诊部就诊的人数超过 60 万。该人群涉及刑事司法的风险了解甚少。本研究的目的是描述急诊治疗后因袭击受伤且有药物滥用史的高危青少年的逮捕情况。
2009 年 12 月至 2011 年 9 月，在急诊部因袭击或非暴力原因就诊且过去 6 个月有药物使用史的 18-24 岁青少年参加了一项为期 2 年的纵向研究。在 2016-2017 年期间，使用客观执法信息网络数据的生存分析分析了急诊就诊后 24 个月内的逮捕情况。使用 Cox 回归估计了被捕风险因素之间的关联的风险比。
在纵向队列中，共有 511 名寻求急诊护理的青少年（受伤组 n=299，对照组 n=212）年龄≥18 岁并纳入分析。受伤组队列的青少年被捕风险比对照组高 47%（38.1%比 25.9%，RR=1.47，p<0.05）。在未调整的分析中，男性、袭击伤、狂饮、药物使用障碍和社区暴力暴露均与随访期间被捕风险增加相关。Cox 回归确定，男性（风险比=2.57）、药物使用障碍诊断（风险比=1.42）、基线时的袭击伤（风险比=1.63）和社区暴力暴露（风险比=1.35）增加了被捕风险。
使用药物且因袭击受伤的青少年被捕率较高。针对药物使用和暴力参与的急诊和社区干预措施可能有助于减少高危青少年的负面暴力和刑事司法结果。
本研究在 www.clinicaltrials.gov 注册，NCT01152970。
