Hospital treatment plans must address adolescents' risks for violence

When adolescents are treated in an emergency department (ED) after being assaulted, they have a significant chance of being involved in another violent encounter soon afterward, according to a study being presented Monday, May 3 at the Pediatric Academic Societies (PAS) annual meeting in Vancouver, British Columbia, Canada.

"Violence is known to be common among adolescents growing up in urban environments, and many emergency departments treat adolescent victims of violence every day. But what they experience when they go home, back to school or back out into the streets is unknown," said Douglas J. Wiebe, PhD, lead author of the study from The Children's Hospital of Philadelphia.

Dr. Wiebe's team conducted a survey using an interactive voice response system to determine the incidence of violent experiences among 12- to 19-year-olds following discharge from the ED. Participants used the phone keypad to answer recorded questions about retaliation and other experiences related to violence for the eight weeks since the event that brought them to the ED in the first place.

Of the 95 patients enrolled, 42 completed the survey. Results showed that within weeks of being treated in the ED, 56 percent of the adolescents avoided certain places, 47 percent considered retaliating, 38 percent had been threatened and 27 percent carried a weapon.

Involvement in subsequent violence related to the event was common: 18 percent had been beaten up, 21 percent had beaten up someone else, 3 percent had been shot or stabbed, and 3 percent had shot or stabbed someone else.

"Violence among urban adolescents is common, and the hospital emergency department is one of the few places adolescents may have contact with the health system," said Dr. Wiebe, assistant professor of epidemiology in the Department of Biostatistics and Epidemiology at the University of Pennsylvania School of Medicine. "If those most at risk can be identified at the time they receive hospital treatment, it may be possible to intervene at that point and improve their chances for safe living in the future."