Assault related injuries among youth in an urban emergency department

Abstract

Background: It is critical to understand the trajectory of youth who present to the emergency department (ED) for an assault- related injury. Objectives: Understanding the past experiences with violence, substance use, gang involvement, and sexual risk behaviors of these high-risk youth compared to a matched sample of youth seeking care for other reasons will aid development of ED-based interventions for assault injured youth. Methods: Youth 14-24 presenting to an urban ED from January - September 2010 with an assault- related injury completed a self administered computerized survey. A systematically sampled comparison group matched by age and sex was recruited. Validated screening questions included demographics, substance use, past partner violence, weapon victimization, and gang involvement. Results: Seven hundred and forty-five youth were screened (15% participation rate). Four hundred and five youth entered the ED with an assault-related injury during study hours, 297 completed screening (11% missed; 15% refused); 53.8% were male, 63.0% were African-American, 50% were in school, 69% receive public assistance, 3% endorsed gang involvement, and 26% were married/living with partner. No significant differences were found in demographics between groups. of the assault-injured youth, 40% have children, 74% report recent weapon victimization, 18% weapon aggression, 60% marijuana use, 14% misuse of prescription drugs, 34% binge drinking, and 32% reported a prior STD. Bivariate analysis found no differences between the assault-injured youth and the matched comparison group on insurance status, living with a parent, working or being in school, alcohol use, or misuse of prescription drugs, and gun carriage. Logistic regression found victimization with a weapon (OR 4.3, CI 3.1-6.1), prior partner violence (OR 1.9, CI 1.4-2.7), prior STD (OR 1.6, CI 1.1-2.3), and problem use of marijuana (OR 1.6 CI 1.1-2.2) predicted an assault-related injury. Conclusion: Assault-injured youth seeking ED care have high rates of recent violence compared to youths seeking ED care for other reasons. Many of these youths experiencing assault injury have children, and live with a partner currently. The ED may be critical time to interact with these high-risk youth to prevent violence in their own lives, as well as the lives of their family and children.