Objective
Assault is a common cause of youth emergency department (ED) visits. Little is known about prior ED utilization patterns among assault-injured youth. This study’s objectives were to determine whether, and how, prior ED visit history distinguishes assault-injured youth from unintentionally injured youth.
Methods
A five-year retrospective, case-control study was conducted using a hospital-billing database. Youth ages 13 to 24 years presenting to the ED of an urban Level I Trauma center in 2011 with an E-code of physical assault-or weapon-related injuries were compared 1:1 to randomly assigned, age- and sex- matched controls with an E-code corresponding to unintentional injury. Bivariate, t-test, Wilcoxon rank sum tests, and conditional logistic regression were performed to determine how previous ED visits distinguished assault-injured youth from unintentionally injured youth.
Results
In 2011, 964 patients presented with assault-related injuries. Over the previous five years, assault-injured youth had a median of 1 prior ED visit (Interquartile range (IQR): 0 – 3); unintentionally injured youth had a median of zero prior ED visits (IQR: 0 – 2). Assault-injured youth had significantly higher median numbers of previous psychiatric and assault-related ED visits when compared to unintentionally injured youth. Youth with one previous psychiatric ED visit had a four-fold increased odds (AOR 4.05, 95% CI 2.41–6.83) of having a 2011 assault-related ED visit compared to unintentionally injured youth.
Conclusion
Assault-injured youth are more likely to have had prior ED use particularly for psychiatric illnesses and assault-related injury. Targeted youth violence screening may be appropriate for such patients.