Ryan Leticia Manning, Irvin Nathan, Miller Mattea, Walter Creason, Jones Vanya
Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Int J Inj Contr Saf Promot. 2022 Mar;29(1):23-28. doi: 10.1080/17457300.2021.1993267. Epub 2021 Nov 1.
This retrospective cohort study at an urban academic pediatric emergency department (ED) in the United States identified all visits for youth 10-15 years of age for injury due to intentional interpersonal violence between January 2019 and December 2020. Demographic and clinical data were abstracted, including circumstances of the event. Data analysis included a comparison of pre-pandemic visits to pandemic visits after a statewide stay-at-home order was issued (March 30, 2020). Of 2780 10-15 year old youth evaluated for any injury, 819 (29.5%) had intentional/violence-related injuries. Most patients were male (53.1%), Black/African-American (84.1%), and were enrolled in a public insurance plan (75.0%). Although peer-violence related injuries comprised a substantial proportion (19.2%), the majority resulted from family violence (54.7%), which may include child maltreatment or physical fighting. Most injuries occurred at home (53.9%). Alcohol, drugs and weapons were significantly more likely to be involved in violent events during the pandemic in comparison to pre-pandemic (12.5 vs 5.0%, 11.4% vs 3.0%, 30.4% vs 8.5%; p < 0.001). Our findings support the need for ED-based efforts to screen and intervene for family and peer violence and other contributory factors (including personal, family and peer alcohol, drug and weapons access) when youth present with intentional injuries, which can be critical to preventing future violence.
这项在美国一家城市学术性儿科急诊科开展的回顾性队列研究,确定了2019年1月至2020年12月期间10至15岁青少年因人际间故意暴力导致受伤的所有就诊情况。提取了人口统计学和临床数据,包括事件发生的具体情况。数据分析包括对全州发布居家令后(2020年3月30日)疫情期间就诊情况与疫情前就诊情况进行比较。在2780名接受过任何损伤评估的10至15岁青少年中,819人(29.5%)有故意/暴力相关损伤。大多数患者为男性(53.1%),黑人/非裔美国人(84.1%),并参加了公共保险计划(75.0%)。虽然同伴暴力相关损伤占相当比例(19.2%),但大多数损伤是由家庭暴力导致的(54.7%),这可能包括虐待儿童或肢体冲突。大多数损伤发生在家中(53.9%)。与疫情前相比,疫情期间暴力事件中酒精、毒品和武器的涉入可能性显著更高(12.5%对5.0%,11.4%对3.0%,30.4%对8.5%;p<0.001)。我们的研究结果支持,当青少年出现故意损伤时,有必要在急诊科开展筛查并干预家庭和同伴暴力及其他促成因素(包括个人、家庭和同伴获取酒精、毒品和武器的情况),这对于预防未来暴力可能至关重要。