Pediatric violence-related injuries in Boston: results of a city-wide emergency department surveillance program.
BACKGROUND
Violence-related injuries among children are common, but age-based incidence data are not easily available.


OBJECTIVE
To describe injuries due to violence in a population-based case series of children and to estimate injury incidence.


METHODS
Prospective surveillance of children residing in Boston, Mass, who received pediatric emergency department treatment for violence-related injury during a 4-year period beginning April 15, 1995.


METHODS
Pediatric emergency departments in Boston.


METHODS
Children aged 3 through 18 years who came to a hospital emergency department between April 1995 and April 1999. Violence-related injuries were defined as those resulting from a situation of conflict involving 2 or more persons with intent to harm, as assessed by health care personnel caring for the patients. Self-inflicted injuries and injuries caused by child abuse (including any injury resulting from a conflict with a parent or guardian) were excluded. Homicides of Boston children aged 3 through 18 years who were killed during the study period were included based on police data.


METHODS
Population-based violence-related injury rates.


RESULTS
There were 2035 injury-related visits caused by violence, which reflects a rate of 52.7 (95% confidence interval, 50.5-54.9) per 10 000 person-years. Most injuries were relatively minor; 6.4% of visits resulted in admission. The youth violence-related injury rate in Boston declined at an average rate of 12% annually during the period studied.


CONCLUSIONS
Pediatric emergency department monitoring of violence-related injury in Boston suggests that childhood injuries due to violence declined during the late 1990s.
Sege
Robert D
RD
Pediatric and Adolescent Health Research Center, the Floating Hospital for Children's National Medical Center, New England Medical Center, Boston, MA, USA. rsege@lifespan.org
Kharasch
Sigmund
S
Perron
Cathy
C
Supran
Stacey
S
O'Malley
Patricia
P
Li
Wenjun
W
Stone
David
D
D000046:Academic Medical Centers / Q000706:statistics & numerical data; D000293:Adolescent; D017677:Age Distribution; D001900:Boston / Q000453:epidemiology; D002648:Child; D002669:Child Welfare / Q000706:statistics & numerical data* / Q000639:trends; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D006769:Hospitals, General / Q000706:statistics & numerical data; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D011159:Population Surveillance; D011446:Prospective Studies; D012044:Regression Analysis; D012189:Retrospective Studies; D017678:Sex Distribution; D014504:Urban Health / Q000706:statistics & numerical data* / Q000639:trends; D014754:Violence / Q000706:statistics & numerical data* / Q000639:trends; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000209:etiology*