title: Emergency Department Utilization Among Assault-Injured Youth: Implications for Youth Violence Screening.
abstract: OBJECTIVE
  Assault is a common cause of youth emergency department (ED) visits. Little is known about prior ED utilization patterns among assault-injured youth. This study's objectives were to determine whether, and how, prior ED visit history distinguishes assault-injured youth from unintentionally injured youth.
  
  
  METHODS
  A 5-year retrospective, case-control study was conducted using a hospital billing database. Youth ages 13 to 24 years presenting to the ED of an urban level 1 trauma center in 2011 with an E-code of physical assault- or weapon-related injuries were compared 1:1 to randomly assigned, age- and sex-matched controls with an E-code corresponding to unintentional injury. Bivariate, t test, Wilcoxon rank sum tests, and conditional logistic regression were performed to determine how previous ED visits distinguished assault-injured youth from unintentionally injured youth.
  
  
  RESULTS
  In 2011, 964 patients presented with assault-related injuries. Over the previous 5 years, assault-injured youth had a median of 1 prior ED visit (interquartile range, 0-3); unintentionally injured youth had a median of zero prior ED visits (interquartile range, 0-2). Assault-injured youth had significantly higher median numbers of previous psychiatric and assault-related ED visits when compared to unintentionally injured youth. A youth with 1 previous psychiatric ED visit had a 4-fold increased odds (adjusted odds ratio [AOR], 4.05; 95% confidence interval, 2.41-6.83) of having a 2011 assault-related ED visit compared to unintentionally injured youth.
  
  
  CONCLUSIONS
  Assault-injured youth are more likely to have had prior ED use particularly for psychiatric illnesses and assault-related injury. Targeted youth violence screening may be appropriate for such patients.
authors.affiliation: From the *Section of Pediatric Emergency Medicine, Department of Emergency Medicine, Alpert Medical School of Brown University; †Injury Prevention Center, Rhode Island Hospital; ‡Department of Pediatrics, and §Department of Emergency Medicine, Alpert Medical School of Brown University, Providence, RI.
authors.forename: Frances
authors.initials: F
authors.lastname: Turcotte Benedict
authors.forename: Siraj
authors.initials: S
authors.lastname: Amanullah
authors.forename: James G
authors.initials: JG
authors.lastname: Linakis
authors.forename: Megan
authors.initials: M
authors.lastname: Ranney
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D019548:Crime Victims / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology*; D012189:Retrospective Studies; D014754:Violence / Q000517:prevention & control / Q000706:statistics & numerical data*; D014947:Wounds and Injuries / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D055815:Young Adult