Pediatric Violence-Related Injuries in Boston

Sege, Robert; Kharasch, Sigmund; Perron, Cathy; Supran, Stacey; O’Malley, Patricia J.; Li, Wenjun; Stone, David A.

doi:10.1001/archpedi.156.1.73

Cited by 25 publications

(5 citation statements)

References 11 publications

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“…In our study, the occurrence of VRPI was statistically significant and more common among men than women (OR = 2.66, 95% CI 1.14-6.23). Based on gender, other studies confirmed our results nationally ( 17 , 18 , 27 ) and internationally ( 20 , 25 ). In our study, the most frequently injured organs were the upper limbs followed by head and neck.…”

Section: Discussionsupporting

confidence: 90%

“…In the USA, VRPI was reported to be 7.56 per 1000 population in 2011 and 7.59 per 1000 population in 2010 ( 19 ). In Boston, VRPI for children aged 3-18 years was estimated at 5.27 (95% CI: 5.05-5.49) in 2002 ( 20 ). In Iran, based on Rahimi-Movaghar’s study, the incidence of VRPI was estimated at 0.77 per 1000 population among 44 cities with 100000-200000 population ( 21 ).…”

Section: Discussionmentioning

confidence: 99%

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Incidence of Self-Reported Interpersonal Violence Related Physical Injury in Iran

Salamati¹,

Rahimi‐Movaghar²,

Motevalian³

et al. 2015

Iran Red Crescent Med J

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Background:Violence is the cause of death for 1.5 million people in a year.Objectives:Our study aimed to estimate the incidence rate of self-reported interpersonal violence related physical injury (VRPI) and its associated factors in Iran.Patients and Methods:The sample included people ranged from 15 to 64 years old who were residing in Iran. A total of 1525 clusters were selected from the whole country. Six families were selected from each cluster via a systematic random sampling method. Then, the residential units were identified and the interviewers contacted the inhabitants. In the next step, one of the family members was selected by using Kish grid method. The instrument was a researcher-made questionnaire and consisted of two sections; demographics and project related data. Face validity and content validity of our questionnaire were investigated based on expert opinions and the reliability was confirmed by a pilot study, as well. The inclusion criteria were considered for choosing the interviewers. An interviewer was assigned for each 42 participants (7 clusters). An educational seminar was held for the administrative managers (54 persons) and interviewers (230 persons) for a week. The field work was distributed among all 46 Medical Sciences universities in Iran. In each university, administrative issues were related to an executive director. Mann-Whitney U test and odds ratio were used to analyze the data with 95% confidence interval. α value was considered less than 5%.Results:The frequency of VRPI among 7886 participants was 24 during the last three months. The incidence rate of interpersonal VRPI was estimated at 3.04 per 1000 population (95% CI: 2.66-3.42) during a three-month interval in Iran. The incidence was 4.72 per 1000 population (95% CI: 4.01-5.43) for males and 1.78 per 1000 population (95% CI: 1.39-2.17) for females during a three-month interval. The mean (SD) of age of the participants with and without a history of VRPI were 26.5 (7.21) and 33.05 (12.05) years, respectively (P = 0.008). Considering the participants’ gender, 66.7% were males (OR = 2.66, 95% CI: 1.14-6.23). Khuzestan Province had the most VRPIs (25% of all VRPIs). Streets and roads were the places with the highest frequency of injury (50%). The most frequent injured organ was the upper limb (54.17%). The most prevalent type of injury was a superficial wound (50%). Finally, the most common place of treatment was home (45.83%).Conclusions:We determined the incidence rate of self-reported interpersonal VRPI for the first time in Iran based on a national survey. The injuries were more common among young men. We suggest consecutive national surveys with different data gathering methods and more sample sizes.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Incidence of Self-Reported Interpersonal Violence Related Physical Injury in Iran

Salamati¹,

Rahimi‐Movaghar²,

Motevalian³

et al. 2015

Iran Red Crescent Med J

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“…A Boston pediatric ED surveillance study demonstrated that only 6.4% of patients requiring treatment for violence-related injuries required hospital admission. 17 In an Israeli study of youth, 84% were discharged directly from the ED. 18 This high percentage of direct ED discharges highlights the fact that ED staff are often the only health care workers who treat patients after violent injuries.…”

Section: Discussionmentioning

confidence: 99%

Emergency department dispositions among 4100 youth injured by violence: a population-based study

Snider

Lee²

2007

CJEM

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Objective: Concern about youth violence in Canada is growing. Because victims of violence are more likely to become future violent perpetrators, preventative interventions are often based out of inpatient units; however, the question of how often youth who have been injured due to violence are discharged from emergency departments (EDs), or whether there are opportunities for emergency healthcare workers to deliver violence prevention programs, is not known. The primary objectives of this study were to describe the frequency and patterns of violent injuries among youth, to determine how many injured youth are discharged directly from EDs and to estimate the proportion of injured youth who may benefit from ED-based intervention programs. Methods: We conducted an observational study using a population-based database that records information on all ED visits in Ontario. We analyzed age, sex, cause of injury and disposition for all patients aged 12-19 years who presented to Toronto EDs with violent injuries during a 2-year period (April 2002to March 2004. Results: A total of 4100 patients aged 12-19 years visited Toronto EDs with violent injuries during the study period. Assault due to bodily force (in contrast to sharp objects, guns or other) was the most common injury mechanism, accounting for 48.7% of cases (95% confidence interval [CI] 47.1%-50.2%). The majority of patients (89.3%; 95% CI 88.3%-90.2%) were discharged directly from EDs, including 44% of gun-related injuries. Conclusion: In Toronto, a large proportion (89.3%) of youth injured in violent incidents are discharged directly from EDs. There are opportunities to develop ED-based youth violence prevention initiatives. RÉSUMÉObjectif : La violence chez les jeunes au Canada préoccupe de plus en plus. Comme les victimes de violence sont plus susceptibles de devenir eux-mêmes des gens violents par la suite, les interventions de prévention sont souvent basées dans les unités pour patients hospitalisés. On ne sait toutefois pas à quelle fréquence des jeunes blessés par violence reçoivent leur congé des services d'urgence ou s'il serait possible pour les intervenants des services d'urgence de dispenser des programmes de préven-tion de la violence. Cette étude visait principalement à décrire la fréquence et les tendances des blessures par violence chez les jeunes, à déterminer combien de jeunes ainsi blessés obtiennent leur congé directement des services d'urgence et à estimer le pourcentage des jeunes blessés qui pourraient bénéficier d'un programme d'intervention offert dans des services d'urgence.

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“…Because of the likelihood of abusive injury requiring urgent medical care, maltreatment victims as a group were hypothesized to experience greater severity of injury, likelihood of hospitalization, and risk of death in the ED than that of nonmaltreated children (Gilbert et al, 2009;Rovi, Chen, & Johnson, 2004). Similarly young children who presented to the ED for physical abuse were hypothesized to be younger, to have sustained more severe injuries, and to be at greater risk of hospitalization and death in the ED setting than children who experienced other types of maltreatment (Sege et al, 2002). Because personnel in the ED primarily focus on stabilizing emergent patients, recognition and diagnosis of neglect were expected to be less commonly identified in the ED than in physical abuse.…”

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confidence: 99%

Maltreatment-Related Emergency Department Visits Among Children 0 to 3 Years Old in the United States

King¹,

Farst

Jaeger

et al. 2015

Child Maltreat

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The emergency department (ED) is a vital entry point in the health care system for children who experience maltreatment. This study fills a gap in the maltreatment literature by presenting systematic, national estimates of maltreatment-related ED visits in the United States by children ≤3 years old, from 2006 to 2011, using the Nationwide Emergency Department Sample (NEDS). Children who experienced and likely experienced maltreatment were identified via International Classification of Diseases, Ninth Revision, Clinical Modification diagnostic codes. Maltreatment was classified as physical or sexual abuse, neglect, or poly-victimization. The clinical and demographic profiles of children who experienced maltreatment were described. Approximately 10,095 children who experienced maltreatment (0.1% of total ED visits) and 129,807 children who likely experienced maltreatment (1.2% of total ED visits) were documented each year. Maltreatment was associated with significantly greater risk of injury, hospitalization, and death in the ED setting. Physical abuse was the most common explicit maltreatment diagnosis (33 ED visits per 100,000 children ≤3 years old) and neglect was the most common likely maltreatment diagnosis (436 ED visits per 100,000 children ≤3 years old). This study established the NEDS as a valuable complement to existing surveillance efforts of child maltreatment from a public health perspective.

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Pediatric Violence-Related Injuries in Boston

Cited by 25 publications

References 11 publications

Incidence of Self-Reported Interpersonal Violence Related Physical Injury in Iran

Incidence of Self-Reported Interpersonal Violence Related Physical Injury in Iran

Emergency department dispositions among 4100 youth injured by violence: a population-based study

Maltreatment-Related Emergency Department Visits Among Children 0 to 3 Years Old in the United States

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