Abstract
|
Background:
Information is lacking on the risks of future harm for adolescents
hospitalised in England as an emergency with adversity-related injury
(violent, self-inflicted, drug/alcohol-related). Evidence is needed on who is
most at risk and the types of harm, to inform preventive strategies. Methods:
Using Hospital Episode Statistics linked to Office for National Statistics
mortality data for England (April 1997-March 2012), I estimated the
prevalence of emergency admissions for adversity-related injury among 10-19y
olds, and identified risk factors. I examined the risks of death and
emergency re-admission after discharge from adversity-related injury,
compared with after accident-related injury. Results: 1 in 25 adolescents had
an emergency admission for adversity-related injury between the ages of 10
and 19y. Among these adolescents, 73% of girls and 38% of boys were admitted
with more than one type (e.g., self-inflicted and drug/alcohol-related). In
addition, 1/137 girls and 1/64 boys with adversity-related injury died within
ten years after discharge; 54% of girls and 41% of boys were re-admitted as
an emergency. These risks were approximately double those following
accident-related injury, regardless of whether violent, self-inflicted or
drug/alcohol-related, and were particularly high for older boys and
adolescents with chronic conditions. Increased risks of death were mostly
explained by suicide and drug/alcohol-related deaths. After each type of
adversity-related injury, risks of drug/alcohol-related deaths were similar
to those of suicide deaths. Conclusions: 1 in 25 adolescents in England were
admitted as an emergency to hospital for adversity-related injury, often with
multiple types of adversity-related injury, and were at considerable risks of
harm in the next decade compared to other adolescents. Current strategies to
reduce risks after self-inflicted injury in this group should be extended to
violent and drug/alcohol-related injury. Strategies could include targeting
older adolescents with chronic conditions, and prioritising risks of
drug/alcohol-related death alongside those of suicide death.
|