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Pediatric Violence-Related Injuries in Boston
Results of a City-Wide Emergency Department Surveillance Program
Robert D. Sege, MD, PhD;
Sigmund Kharasch, MD;
Cathy Perron, MD;
Stacey Supran, MA;
Patricia O'Malley, MD;
Wenjun Li, PhD;
David Stone, PhD
Arch Pediatr Adolesc Med. 2002;156:73-76.
Context Violence-related injuries among children are common, but age-based incidence
data are not easily available.
Objectives To describe injuries due to violence in a population-based case series
of children and to estimate injury incidence.
Design Prospective surveillance of children residing in Boston, Mass, who received
pediatric emergency department treatment for violence-related injury during
a 4-year period beginning April 15, 1995.
Setting Pediatric emergency departments in Boston.
Patients Children aged 3 through 18 years who came to a hospital emergency department
between April 1995 and April 1999. Violence-related injuries were defined
as those resulting from a situation of conflict involving 2 or more persons
with intent to harm, as assessed by health care personnel caring for the patients.
Self-inflicted injuries and injuries caused by child abuse (including any
injury resulting from a conflict with a parent or guardian) were excluded.
Homicides of Boston children aged 3 through 18 years who were killed during
the study period were included based on police data.
Main Outcome Measure Population-based violence-related injury rates.
Results There were 2035 injury-related visits caused by violence, which reflects
a rate of 52.7 (95% confidence interval, 50.5-54.9) per 10 000 person-years.
Most injuries were relatively minor; 6.4% of visits resulted in admission.
The youth violence-related injury rate in Boston declined at an average rate
of 12% annually during the period studied.
Conclusion Pediatric emergency department monitoring of violence-related injury
in Boston suggests that childhood injuries due to violence declined during
the late 1990s.
From the Pediatric and Adolescent Health Research Center, the Floating
Hospital for Children's National Medical Center (Drs Sege and Stone); Department
of Pediatrics, Boston Medical Center (Dr Kharasch); Department of Emergency
Medicine, the Children's Hospital (Dr Perron); Division of Clinical Care Research,
New England Medical Center (Ms Supran and Dr Li); and the Departments of Pediatrics
and Emergency Medicine, Massachusetts General Hospital (Dr O'Malley), Boston.
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