University of Maryland Medical Center, Emergency Medicine, 110 S Paca St 6th Fl, Suite 200 Baltimore, 21201-1595 MD, USA.
Khayelitsha Hospital, Emergency Medicine Khayelitsha, South Africa.
Injury. 2019 Dec;50(12):2220-2227. doi: 10.1016/j.injury.2019.10.014. Epub 2019 Oct 7.
Violence is a leading cause of death worldwide for youth age 15-29. A growing body of literature has described assault-injured youth in United States emergency centres, identifying risk factors for re-injury and mortality, and developing targeted interventions. Despite the fact that low- and middle-income countries are disproportionately affected by violence, little research on assault-injured youth exists in these settings.
Survey and chart review of 14 to 24-year-old assault-injured patients and non-assault-injured controls to 24-hour emergency centres in Khayelitsha, South Africa over 15 weeks. Patient enrollment occurred 7pm Friday to 7am Monday. Multivariable logistic regression was used to estimate associations of behavioral and other factors with assault injury.
In total 513 patients were enrolled: 324 assault-injured patients and 189 controls (131 medical, 58 unintentional injuries). Overall 28% were female (n = 146) and 72% were male (n = 367). The mean age was 20.5 years. Assault-injured patients of both genders were more likely than controls to give a 30-day history of drinking any alcohol (OR 6.3) and binge drinking (OR 6.7). They were also more likely to report any physical fight (OR 4.4) or any physical fight requiring medical care in the past 6 months (OR 5.08), and lifetime history of arrest (OR 5.1) or conviction (OR 6.7). Drugs and/or alcohol were used by victims prior to 78% of the assaults. Significant differences were not detected between females (76%) and males (79%). Overall, 47% of assault-injured youth and 15% of controls reported a history of a fight requiring medical treatment in the past 6 months.
Violence is a chronic and recurring disease, suggesting opportunities for interventions during health care contacts. Our population of assault-injured youth demonstrated significant rates of alcohol use and binge drinking, as well as alcohol use prior to the assault. Future secondary violence prevention initiatives should consider targeting alcohol use and abuse.
暴力是全球 15-29 岁青年死亡的主要原因。越来越多的文献描述了美国急诊中心遭受袭击受伤的年轻人，确定了再次受伤和死亡的风险因素，并制定了有针对性的干预措施。尽管中低收入国家受到暴力的影响不成比例，但在这些环境中，关于遭受袭击受伤的年轻人的研究很少。
在南非开普敦的 24 小时急诊中心，对 14 至 24 岁的遭受袭击受伤的患者和非遭受袭击受伤的对照者进行了为期 15 周的调查和图表回顾。患者登记发生在周五晚上 7 点至周一早上 7 点。使用多变量逻辑回归估计行为和其他因素与袭击受伤的关联。
共登记了 513 名患者：324 名遭受袭击受伤的患者和 189 名对照者（131 名医疗，58 名非故意伤害）。总体而言，28%为女性（n=146），72%为男性（n=367）。平均年龄为 20.5 岁。与对照组相比，两性遭受袭击受伤的患者更有可能在 30 天内报告饮酒（OR 6.3）和狂饮（OR 6.7）。他们也更有可能报告过去 6 个月内任何身体打架（OR 4.4）或任何需要医疗护理的身体打架（OR 5.08），以及一生中被捕（OR 5.1）或定罪（OR 6.7）的历史。在 78%的袭击事件之前，受害者使用了毒品和/或酒精。未发现女性（76%）和男性（79%）之间存在显著差异。总体而言，47%的受袭击受伤的年轻人和 15%的对照者报告过去 6 个月内有过需要医疗治疗的打架事件。
暴力是一种慢性和反复发作的疾病，这表明在医疗保健接触期间有机会进行干预。我们的受袭击受伤的年轻人群体显示出相当高的饮酒和狂饮率，以及袭击前饮酒的情况。未来的二级暴力预防计划应考虑针对酒精使用和滥用。
