TY - JOUR PY - 2015// TI - Emergency department visits for self-inflicted injuries in adolescents JO - Pediatrics A1 - Cutler, Gretchen J. A1 - Flood, Andrew A1 - Dreyfus, Jill A1 - Ortega, Henry W. A1 - Kharbanda, Anupam B. SP - 28 EP - 34 VL - 136 IS - 1 N2 - 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.

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.

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).

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.

Language: en

LA - en SN - 0031-4005 UR - http://dx.doi.org/10.1542/peds.2014-3573 ID - ref1 ER -