Assault Related in juries in Children and Adolescents Presenting to the Emergency Room

Abstract

Background: Children and adolescents are particularly vulnerable to violence and its long lasting effects. Physical violence frequently brings its victims to seek care in emergency departments and first line physicians play an important role in the detection and the prevention of this type of aggression. Objective: To describe injuries related to physical aggression in youth 5 to 19 years old presenting to an urban emergency department, their tendencies over a ten year period, and identify risk factors to guide their prevention. Methods: We used retrospective data from the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) available from one urban paediatric tertiary center. Intentional injuries inflicted by other youth were examined over a study period from 1998 to 2007. For each case, the age and sex were recorded. The age groups were divided into three: 5-9 years, 10-14 years and 15-19 years. Injuries were characterized according to type, body part involved, place where they occurred, mechanism and disposition of the patient. As a second step, we will study postal code link to socioeconomic status and evolutions of injury characteristic trends over ten years. Results: During the studied period, a total of 504 visits for non accidental physical injuries were identified. There were 395 (78%) males and 109 (22%) females. Thirty nine (8%), 251 (50%) and 214 (42%) patients belonged to the 5-9 years, 10-14 years and 15-19 years groups respectively. Injuries were superficial (23%), open wounds (21%), concussions (19%) and fractures (17%). The body parts involved most frequently were the head (34%), the face (29%) and the upper extremity (14%). For the cases where information was available, 50% of injuries occurred at school (153 of 306), and 63% involved bodily force (190 of 300). Twenty-five (5%) were admitted to the hospital. Among those, the injuries resulted in more severe open wounds (36%), fractures (32%) or concussions (20%). Conclusion: In this study, most injuries related to physical aggression in youth occurred in 10 to 19 year old boys, were not severe, involved the head and face, occurred at school and resulted from bodily force. Only a small minority of patients were admitted. Youth that have already been assaulted can be targeted for intervention and follow-up in order to manage the physical and psychological sequelae, as well as prevent their repeated victimisation, their possible evolution into perpetrators and enhance their empowerment