Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts.
Division of Emergency Medicine, Boston Children's Hospital, Boston, Massachusetts.
J Adolesc Health. 2023 Sep;73(3):486-493. doi: 10.1016/j.jadohealth.2023.04.011. Epub 2023 Jun 8.
This study aimed to explore the health outcomes of adolescent survivors of sexual assault, as measured by subsequent emergency department (ED) utilization for mental and sexual health concerns.
This retrospective cohort study used the Pediatric Health Information System (PHIS) database. We included patients aged 11-18 years seen at a PHIS hospital with a primary diagnosis of sexual assault. The control group included age- and sex-matched patients seen for an injury. Participants were followed in PHIS for 3-10 years; subsequent ED visits for suicidality, sexually transmitted infection, pelvic inflammatory disease (PID), or pregnancy were identified, and likelihoods of each were compared using Cox proportional hazards models.
The study population included 19,706 patients. ED return visit rates in the sexual assault and control groups were 7.9% versus 4.1% for suicidality, 1.8% versus 1.4% for sexually transmitted infection, 2.2% versus 0.8% for PID, and 1.7% versus 1.0% for pregnancy, respectively. Compared to controls, sexual assault patients were significantly more likely to return to the ED for suicidality throughout the follow-up period, with the highest hazard ratio of 6.31 (95% confidence interval 4.46-8.94) during the first 4 months. Sexual assault patients also had higher likelihood of returning for PID (hazard ratio 3.80, 95% confidence interval 3.07-4.71) throughout the follow-up period.
Adolescents seen in the ED for sexual assault were significantly more likely to return to the ED for suicidality and sexual health concerns, highlighting the need for increased allocation of research and clinical resources to improve their care.
本研究旨在探讨性侵犯后青少年幸存者的健康结果，以随后因精神和性健康问题而到急诊就诊来衡量。
这是一项回顾性队列研究，使用了儿科健康信息系统（PHIS）数据库。我们纳入了在 PHIS 医院就诊的年龄在 11-18 岁之间、主要诊断为性侵犯的患者。对照组包括因受伤就诊的年龄和性别匹配的患者。参与者在 PHIS 中随访 3-10 年；确定了随后因自杀意念、性传播感染、盆腔炎（PID）或怀孕而到急诊就诊的情况，并使用 Cox 比例风险模型比较了每种情况的可能性。
本研究人群包括 19706 名患者。性侵犯组和对照组的急诊就诊率分别为自杀意念 7.9%和 4.1%，性传播感染 1.8%和 1.4%，PID 2.2%和 0.8%，以及怀孕 1.7%和 1.0%。与对照组相比，性侵犯患者在整个随访期间更有可能因自杀意念而再次到急诊就诊，在头 4 个月时风险比最高，为 6.31（95%置信区间 4.46-8.94）。性侵犯患者在整个随访期间因 PID 而再次就诊的可能性也更高（风险比 3.80，95%置信区间 3.07-4.71）。
因性侵犯到急诊就诊的青少年更有可能因自杀意念和性健康问题再次到急诊就诊，这突出表明需要增加研究和临床资源的分配，以改善他们的护理。
