Self-harm, Assault, and Undetermined Intent Injuries among Pediatric Emergency Department Visits

Research output: Contribution to journalArticle

Abstract

Objectives Although injuries are a known cause of morbidity and mortality among children and adolescents, little is known about the epidemiology of injury-related emergency department (ED) visits in the United States by injury intent. The objective of this analysis was to examine ED outcomes, defined as death in the ED, inpatient admission, and visit cost, among ED visits stratified by injury intent (ie, self-harm, assault, and injury with undetermined intent, as compared with unintentional injuries). Methods All injury-related ED visits in the United States for children and adolescents, ages 8 to 17 years, were identified using the 2008 Nationwide Emergency Department Sample. Multivariate survey weighted logistic and linear regression analyses were then used to estimate the likelihood of death on ED visit, inpatient admission, and cost across the 4 injury types. Results In 2008, with the use of weighted estimates, there were 66,895 self-harm, 176,125 assault, 24,144 undetermined injury, and 4,244,589 unintentional injury ED visits among children 8 to 17 years. Visits due to self-harm, assault and undetermined injuries were more likely to result in death during the ED visit compared with visits due to unintentional injuries. Self-harm and undetermined intent were also associated with greater odds of inpatient admission as well as 90% and 60% higher ED visit costs, respectively. Conclusions Data from this nationwide sample of pediatric ED visits highlight the resource burden of self-harm, undetermined intent, and assault injury visits. Pediatric EDs may provide a window of opportunity for better case identification and intervention with children experiencing violence and injury.

Original languageEnglish (US)
Pages (from-to)813-818
Number of pages6
JournalPediatric Emergency Care
Volume31
Issue number12
DOIs
StatePublished - Dec 1 2015

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Hospital Emergency Service
Pediatrics
Wounds and Injuries
Inpatients
Costs and Cost Analysis
Child Mortality
Violence
Linear Models
Epidemiology
Logistic Models
Regression Analysis
Morbidity

Keywords

  • assaultive behavior
  • costs and cost analysis
  • Emergency service hospital
  • epidemiology
  • injuries
  • suicide, attempted

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Emergency Medicine

Cite this

@article{9edb873bc2244715898866143631e9d5,
title = "Self-harm, Assault, and Undetermined Intent Injuries among Pediatric Emergency Department Visits",
abstract = "Objectives Although injuries are a known cause of morbidity and mortality among children and adolescents, little is known about the epidemiology of injury-related emergency department (ED) visits in the United States by injury intent. The objective of this analysis was to examine ED outcomes, defined as death in the ED, inpatient admission, and visit cost, among ED visits stratified by injury intent (ie, self-harm, assault, and injury with undetermined intent, as compared with unintentional injuries). Methods All injury-related ED visits in the United States for children and adolescents, ages 8 to 17 years, were identified using the 2008 Nationwide Emergency Department Sample. Multivariate survey weighted logistic and linear regression analyses were then used to estimate the likelihood of death on ED visit, inpatient admission, and cost across the 4 injury types. Results In 2008, with the use of weighted estimates, there were 66,895 self-harm, 176,125 assault, 24,144 undetermined injury, and 4,244,589 unintentional injury ED visits among children 8 to 17 years. Visits due to self-harm, assault and undetermined injuries were more likely to result in death during the ED visit compared with visits due to unintentional injuries. Self-harm and undetermined intent were also associated with greater odds of inpatient admission as well as 90{\%} and 60{\%} higher ED visit costs, respectively. Conclusions Data from this nationwide sample of pediatric ED visits highlight the resource burden of self-harm, undetermined intent, and assault injury visits. Pediatric EDs may provide a window of opportunity for better case identification and intervention with children experiencing violence and injury.",
keywords = "assaultive behavior, costs and cost analysis, Emergency service hospital, epidemiology, injuries, suicide, attempted",
author = "Ballard, {Elizabeth D.} and Luther Kalb and Vasa, {Roma A} and Goldstein, {Mitchell A} and Holly Wilcox",
year = "2015",
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doi = "10.1097/PEC.0000000000000627",
language = "English (US)",
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pages = "813--818",
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T1 - Self-harm, Assault, and Undetermined Intent Injuries among Pediatric Emergency Department Visits

AU - Ballard, Elizabeth D.

AU - Kalb, Luther

AU - Vasa, Roma A

AU - Goldstein, Mitchell A

AU - Wilcox, Holly

PY - 2015/12/1

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N2 - Objectives Although injuries are a known cause of morbidity and mortality among children and adolescents, little is known about the epidemiology of injury-related emergency department (ED) visits in the United States by injury intent. The objective of this analysis was to examine ED outcomes, defined as death in the ED, inpatient admission, and visit cost, among ED visits stratified by injury intent (ie, self-harm, assault, and injury with undetermined intent, as compared with unintentional injuries). Methods All injury-related ED visits in the United States for children and adolescents, ages 8 to 17 years, were identified using the 2008 Nationwide Emergency Department Sample. Multivariate survey weighted logistic and linear regression analyses were then used to estimate the likelihood of death on ED visit, inpatient admission, and cost across the 4 injury types. Results In 2008, with the use of weighted estimates, there were 66,895 self-harm, 176,125 assault, 24,144 undetermined injury, and 4,244,589 unintentional injury ED visits among children 8 to 17 years. Visits due to self-harm, assault and undetermined injuries were more likely to result in death during the ED visit compared with visits due to unintentional injuries. Self-harm and undetermined intent were also associated with greater odds of inpatient admission as well as 90% and 60% higher ED visit costs, respectively. Conclusions Data from this nationwide sample of pediatric ED visits highlight the resource burden of self-harm, undetermined intent, and assault injury visits. Pediatric EDs may provide a window of opportunity for better case identification and intervention with children experiencing violence and injury.

AB - Objectives Although injuries are a known cause of morbidity and mortality among children and adolescents, little is known about the epidemiology of injury-related emergency department (ED) visits in the United States by injury intent. The objective of this analysis was to examine ED outcomes, defined as death in the ED, inpatient admission, and visit cost, among ED visits stratified by injury intent (ie, self-harm, assault, and injury with undetermined intent, as compared with unintentional injuries). Methods All injury-related ED visits in the United States for children and adolescents, ages 8 to 17 years, were identified using the 2008 Nationwide Emergency Department Sample. Multivariate survey weighted logistic and linear regression analyses were then used to estimate the likelihood of death on ED visit, inpatient admission, and cost across the 4 injury types. Results In 2008, with the use of weighted estimates, there were 66,895 self-harm, 176,125 assault, 24,144 undetermined injury, and 4,244,589 unintentional injury ED visits among children 8 to 17 years. Visits due to self-harm, assault and undetermined injuries were more likely to result in death during the ED visit compared with visits due to unintentional injuries. Self-harm and undetermined intent were also associated with greater odds of inpatient admission as well as 90% and 60% higher ED visit costs, respectively. Conclusions Data from this nationwide sample of pediatric ED visits highlight the resource burden of self-harm, undetermined intent, and assault injury visits. Pediatric EDs may provide a window of opportunity for better case identification and intervention with children experiencing violence and injury.

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KW - costs and cost analysis

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KW - injuries

KW - suicide, attempted

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