Objectives: To characterize the circumstances of youth intentional violence in emergency department patients and compare circumstances of events between gender and age groups.
Methods: Cross-sectional survey and chart review of a 9-month consecutive sample of 8-year to 24-year-old intentionally injured patients (excluding child abuse or domestic violence) in 3 emergency departments.
Results: Four hundred twenty-six patients were included in the study. Most events were fights and most occurred in the street. Fists, hands, and feet were the most common weapon, and contusions or abrasions the most common injury. Most events involved only 2 people, and most incidents involved friends or acquaintances. Events involving 8 to 14 year olds were more likely to occur in school, to involve only fists, hands, or feet, and involve a friend. Eight to 14 year olds were less likely to use a firearm. Among the younger group, females were more likely than males to be injured in an assault, sustain a contusion or abrasion, and be involved in an incident with multiple participants. Older females were more likely than males to be involved in an event in the home, and sustain a contusion, abrasion, or bite.
Conclusions: This study characterizes the circumstances of youth intentional violence that result in emergency department visits for injuries. Although similarities exist between different age groups and genders, some key differences between the groups are illustrated. Understanding the differences between violent events in different age groups and genders may help clinicians recognize injury patterns and possibly guide alternative interventions.
Interpersonal violence is pervasive in American society. In the United States, the homicide rate among children younger than 15 years old is 5 times greater than the rate among children in 25 other industrialized countries combined, and most of firearm-related deaths in this age group occur in the US. 1 Much research has focused on defining the epidemiology and risk factors for violent behavior; known risk factors include access to firearms, 2 exposure to violence, 3-5 and poor school performance. 6,7 However, the causes, precipitating factors, and relationships of those involved in peer interpersonal violence episodes have not been well described. In addition, little is known about the potentially unique factors that may contribute to violent events involving younger patients and those involving females. Identification of circumstances of violent episodes that are uniquely related to preadolescents, as well as those uniquely related to girls and young women, could ultimately lead to the development of more effective strategies to reduce interpersonal violence among these groups. Furthermore, an understanding of these differences can help physicians obtain more relevant histories from injured patients and will aid in more targeted and appropriate referrals.
The Emergency Department (ED) visit is often the first and only visit to a health care facility for injuries related to interpersonal violence and is an appropriate environment to gather information about interpersonal violence. The objective of this exploratory study is to characterize the circumstances of interpersonal violent events that bring youth to an ED and to compare these circumstances between early adolescents and older adolescents, and between male and female patients.