Self-reported violence-related outcomes for adolescents within eight weeks of emergency department treatment for assault injury.
OBJECTIVE
To estimate, using a novel interactive voice response (IVR) survey, the incidence of self-reported violence-related experiences of adolescent assault-injured patients in the weeks after discharge from the emergency department (ED).


METHODS
In an urban ED, a prospective cohort study with 8-week follow-up IVR survey either weekly, bi-weekly, or monthly after discharge was conducted with patients aged 12–19 years presenting with assault-related injuries. Survival analysis methods were used to estimate cumulative risks of self-reported violence experienced within 4 and 8 weeks.


RESULTS
A total of 95 patients were enrolled; 42 (44.2%) reported to the IVR survey. As a result of the ED index event, an estimated 18.2% (confidence interval [CI]=9.1%–34.6%) reported being assaulted (no weapon), 2.9% (CI = .4%–19.1%) had been shot or stabbed, 20.7% (CI =10.9%–37.3%) had assaulted someone else (no weapon), and 2.9% (CI=.4%–19.1%) shot or stabbed someone else. Additionally, 54.6% (CI=39.6%–70.9%) had avoided going certain places, 47.0% (CI = 32.5%–64.1%) considered retaliating, 38.1% (CI =24.3%–56.3%) had been threatened, and 27.0% (CI =15.4%–44.6%) had carried a weapon. Most outcome occurrences happened within 4 weeks. There was evidence that intent to retaliate when asked at baseline was associated with an elevated risk of several outcomes.


CONCLUSIONS
The risk for subsequent violence among assault-injured adolescent ED patients appears high within weeks of discharge.
Department of Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104-6021, USA. dwiebe@mail.med.upenn.edu
Douglas J
DJ
Wiebe
Mercedes M
MM
Blackstone
Cynthia J
CJ
Mollen
Alison J
AJ
Culyba
Joel A
JA
Fein
D000046:Academic Medical Centers; D000293:Adolescent; D000294:Adolescent Behavior; D002648:Child; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D007407:Interviews as Topic; D008297:Male; D011446:Prospective Studies; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D057566:Self Report; D014505:Urban Population; D014754:Violence / Q000523:psychology* / Q000706:statistics & numerical data*; D014947:Wounds and Injuries / Q000209:etiology / Q000523:psychology*; D055815:Young Adult