Critical Violent Injury in the United States: A Review and Call to Action.
OBJECTIVE
This review provides an overview of what is known about violent injury requiring critical care, including child physical abuse, homicide, youth violence, intimate partner violence, self-directed injury, firearm-related injury, and elder physical abuse.


METHODS
We searched PubMed, Scopus, Ovid Evidence-Based Medicine Reviews, and the National Guideline Clearinghouse. We also included surveillance data from the Centers for Disease Control and Prevention and National Trauma Data Bank.


METHODS
Search criteria limited to articles in English and reports of humans, utilizing the following search terms: intentional violence, intentional harm, violence, crime victims, domestic violence, child abuse, elder abuse, geriatric abuse, nonaccidental injury, nonaccidental trauma, and intentional injury in combination with trauma centers, critical care, or emergency medicine. Additionally, we included relevant articles discovered during review of the articles identified through this search.


METHODS
Two hundred one abstracts were reviewed for relevance, and 168 abstracts were selected and divided into eight categories (child physical abuse, homicide, youth violence, intimate partner violence, self-directed injury, firearm-related injury, and elder physical abuse) for complete review by pairs of authors. In our final review, we included 155 articles (139 articles selected from our search strategy, 16 additional highly relevant articles, many published after we conducted our formal search).


RESULTS
A minority of articles (7%) provided information specific to violent injury requiring critical care. Given what is known about violent injury in general, the burden of critical violent injury is likely substantial, yet little is known about violent injury requiring critical care.


CONCLUSIONS
Significant gaps in knowledge exist and must be addressed by meaningful, sustained tracking and study of the epidemiology, clinical care, outcomes, and costs of critical violent injury. Research must aim for not only information but also action, including effective interventions to prevent and mitigate the consequences of critical violent injury.
1Robert Wood Johnson Foundation Clinical Scholars Program, Yale University School of Medicine, New Haven, CT. 2Pediatric Critical Care Medicine, Yale-New Haven Children's Hospital, New Haven, CT. 3Department of Surgery, Center for Trauma and Critical Care, George Washington University, Washington, DC. 4UT Regional One Physicians, Trauma Surgery, Regional One Health, Memphis, TN. 5General Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA. 6Keck School of Medicine, University of Southern California, Los Angeles, CA. 7Department of Pharmacy and Therapeutics, University of Pittsburgh, School of Pharmacy, Pittsburgh, PA. 8VA Medical Center, Department of Emergency Medicine, Durham, NC.
Carley L
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Babak
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Jane A
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Jeffrey S
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Sandra L
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Kane-Gill
Heatherlee
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Bailey
D000293:Adolescent; D000328:Adult; D026683:Advisory Committees; D000369:Aged, 80 and over; D002423:Cause of Death; D002648:Child; D002649:Child Abuse / Q000517:prevention & control / Q000706:statistics & numerical data; D016638:Critical Illness / Q000401:mortality / Q000628:therapy; D004552:Elder Abuse / Q000517:prevention & control / Q000706:statistics & numerical data; D019317:Evidence-Based Medicine; D005260:Female; D006708:Homicide / Q000517:prevention & control / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D015601:Injury Severity Score; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D000066511:Intimate Partner Violence / Q000517:prevention & control / Q000706:statistics & numerical data; D008297:Male; D020380:Needs Assessment; D018570:Risk Assessment; D016019:Survival Analysis; D014481:United States; D014754:Violence / Q000517:prevention & control / Q000706:statistics & numerical data*; D014947:Wounds and Injuries / Q000401:mortality* / Q000517:prevention & control; D055815:Young Adult