@article{ref1,
title="Emergency department visits for self-inflicted injuries in adolescents",
journal="Pediatrics",
year="2015",
author="Cutler, Gretchen J. and Flood, Andrew and Dreyfus, Jill and Ortega, Henry W. and Kharbanda, Anupam B.",
volume="136",
number="1",
pages="28-34",
abstract="OBJECTIVES: To describe emergency department (ED) visits for self-inflicted injury (SII) among adolescents, examine trends in SII mechanisms, and identify factors associated with increased risk. <br><br>METHODS: Analyses included patients aged 10 to 18 years from the National Trauma Data Bank, years 2009 to 2012. We used Cochran-Armitage trend tests to examine change over time and generalized linear models to identify risk factors for SII. <br><br>RESULTS: We examined 286 678 adolescent trauma patients, 3664 (1.3%) of whom sustained an SII. ED visits for SII increased from 2009 to 2012 (1.1% to 1.6%, P for trend ≤.001), whereas self-inflicted firearm visits decreased (27.3% to 21.9%, P for trend =.02). The most common mechanism in males was firearm (34.4%), and in females, cut/pierce (48.0%). Odds of SII were higher in females (odds ratio [OR] 1.41, 95% confidence interval [CI] 1.13-1.77), older adolescents (OR 2.73, 95% CI 2.38-3.14), adolescents with comorbid conditions (OR 1.64; 95% CI 1.49-1.80), and Asian adolescents (OR 1.67, 95% CI 1.35-2.08) and lower in African American adolescents (OR 0.78, 95% CI 0.70-0.87). Adolescents in the public or self-pay insurance category had higher odds of SII (OR 1.44, 95% CI 1.27-1.64) than those in the private insurance category (OR 1.15, 95% CI 1.01-1.31). Adolescents with an SII had higher odds of death than those with other injuries (OR 12.9, 95% CI 6.78-24.6). <br><br>CONCLUSIONS: We found a significant increase in the number of SIIs by adolescents that resulted in ED visits from 2009 to 2012. Although SIIs increased, we found a significant decrease in the percentage of adolescents who self-injured with a firearm. SIIs reflect a small percentage of ED visits, but these patients have dramatically higher odds of death.<p /> <p>Language: en</p>",
language="en",
issn="0031-4005",
doi="10.1542/peds.2014-3573",
url="http://dx.doi.org/10.1542/peds.2014-3573"
}