Children's National Hospital, Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia.
Children's National Hospital, Division of Emergency Medicine, Washington, District of Columbia.
J Adolesc Health. 2023 Jun;72(6):972-976. doi: 10.1016/j.jadohealth.2022.12.014. Epub 2023 Feb 1.
To measure the risk of a subsequent assault-related emergency department (ED) visit in assault injured adolescents as compared to those who initially presented for non-assault related injuries.
This was a historical cohort study of youth (ages 10-18 years) seen at two pediatric EDs between 2016 and 2019. Participants were included if their visit had an International Classification of Diseases-10 code for assaultive injury or accidental injury (motor vehicle collisions (MVC) and sports injuries). We calculated the rate of a subsequent ED visit for an assault-related injury, and then used survival analysis to compare time to subsequent ED visit with an assault-related injury between study and comparison groups.
A total of 6125 adolescents met inclusion criteria (Assault: n = 2782, 45.4%; MVC: n = 1834, 29.9%; Sports n = 1509, 24.6%). The overall rate per 100 person years of a subsequent assault-related ED visit was 5.6 (n = 344). Patients who initially presented with an assault-related injury had an increased adjusted relative risk (aRR) of return for a subsequent ED visit for an assault-related injury when compared to MVC patients (aRR 17.6 [95% CI: 9.6, 32.2]). Kaplan-Meier time to event analysis found that patients in the assault injury group have a higher probability of a subsequent ED visit for an assault-related injury compared to patients in the MVC injury group (adjusted hazard ratio (aHR): 17.7 [95% CI: 9.67, 32.42]).
Adolescents injured by assault are more likely to return to the ED for a subsequent assault-related injury compared to adolescents who initially present with non-assault-related injuries.
与因非外伤初次就诊的患者相比，评估外伤后青少年再次因外伤相关就诊的风险。
这是一项对 2016 年至 2019 年期间在两家儿科急诊就诊的青少年（年龄 10-18 岁）进行的历史队列研究。如果患者就诊的国际疾病分类第 10 版（ICD-10）编码为外伤，包括意外伤害（机动车碰撞（MVC）和运动损伤），则纳入研究。我们计算了外伤相关的急诊就诊率，然后使用生存分析比较了研究组和对照组再次因外伤相关就诊的时间。
共有 6125 名青少年符合纳入标准（外伤：n=2782，45.4%；MVC：n=1834，29.9%；运动损伤：n=1509，24.6%）。100 人年中再次因外伤相关就诊的发生率为 5.6（n=344）。与 MVC 患者相比，初次因外伤相关就诊的患者再次因外伤相关急诊就诊的校正相对风险（aRR）增加（aRR 17.6[95%CI：9.6，32.2]）。Kaplan-Meier 时间事件分析发现，外伤组患者与 MVC 组患者相比，再次因外伤相关就诊的可能性更高（校正危险比（aHR）：17.7[95%CI：9.67，32.42]）。
与初次就诊为非外伤相关损伤的青少年相比，因外伤受伤的青少年更有可能因再次发生外伤相关损伤而返回急诊就诊。
