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School Suspensions, Injury-Prone Behaviors, and Injury History

Ryb, Gabriel E. MD, MPH; Dischinger, Patricia C. PhD; Smith, Gordon S. MD, MPH; Soderstrom, Carl A. MD

Journal of Trauma and Acute Care Surgery: November 2008 - Volume 65 - Issue 5 - p 1106-1113
doi: 10.1097/TA.0b013e3181847e7d
Original Articles

Purpose: To investigate the association of history of school suspension (HSS) to risky behaviors and injury history.

Methods: Adult patients admitted to a Level I trauma center (n = 774) were assessed for demographics, socioeconomic status, educational history, risky behaviors (infrequent seat belt use, drinking and driving, binge drinking, and speeding for a thrill), substance abuse disorders, and prior injury history. Student’s t test and χ2 statistics were used to compare subjects with and without a HSS in relation to risky behaviors and injury history (α = 0.05). Logistic regression models were constructed with each risky behavior and injury history as the outcome adjusting for demographics, socioeconomic status, and substance abuse disorders.

Results: Patients with HSS (n = 260) were significantly younger, more likely to be male, not married, low income, Black, unemployed, smokers, and alcohol and drug dependent than patients without such history (n = 514). They had higher rates of binge drinking (66% vs. 33%), infrequent seat belt use (50% vs. 26%), drinking and driving (24% vs. 12%), and driving fast for a thrill (21% vs. 8%). Similarly, they had more frequent previous history of vehicular injuries (44% vs. 31%) and assaults (36% vs. 16%). Multivariate models revealed school suspension to be associated with infrequent seat belt use (Odds ratio [OR] = 2.02 [1.44–2.83]), binge drinking (OR = 1.95 [1.25–3.04]), speeding for a thrill (OR = 1.83 [1.15–2.92]), prior vehicular injuries (OR = 1.46 [1.06–2.02]), and assaults (OR = 1.67 [1.13–2.47]).

Conclusion: HSS is associated with risky behaviors, and history of prior vehicular crashes and assaults.

From National Study Center for Trauma and EMS (G.E.R., P.C.D., G.S.S., C.A.S.), University of Maryland Medical School, Baltimore, Maryland; Program in Trauma (G.E.R.), University of Maryland Medical School, Baltimore, Maryland; and Prince Georges Hospital Medical Center (G.E.R.), Cheverly, Maryland.

Submitted for publication April 22, 2008.

Accepted for publication June 24, 2008.

Supported by the National Institute on Alcohol Abuse and Alcoholism grant RO1 AA09050.

Presented at the 21st Annual Meeting of the Eastern Association for the Surgery of Trauma, January 15–19, 2008, Jacksonville, Florida.

Address for reprints: Gabriel E. Ryb, MD, MPH, National Study Center for Trauma and Emergency Medical Systems, 701 West Pratt Street, Fifth Floor, Baltimore, MD 21201; email:

© 2008 Lippincott Williams & Wilkins, Inc.