Repeat assault injury among adolescents utilizing emergency care: A statewide longitudinal study

Background: Violent injuries are a leading cause of morbidity and mortality among youths. Little is known about adolescents patterns of and risk factors for repeat assault injuries, yet understanding who is at risk for repeated assaults is important for intervention and prevention efforts. Investigating these questions in population-based adolescent samples is particularly critical. Objective: Our aim was to estimate the 5-year cumulative incidence of and risk factors for repeat emergency department (ED) visits for assault injury among adolescents experiencing an index assault visit, and compare the method of injury for adolescents first and second visits. Methods: Statewide, longitudinal data from California were used to follow 17,845 adolescents who reported to an ED with assault-related injuries in 2010. Incidence rate ratios were estimated to examine risk factors for repeat assault injury within 1 year and 5 years following the index visit. Results: A total of 3273 (18.3%) assaulted adolescents experienced one or more additional assault injury ED visits during the full follow-up period. Only 37.3% of these repeat assaults occurred within the first year following the index assault. Of adolescents with a repeat assault injury, the method of injury often changed and followed no clear pattern. Sociodemographic characteristics (e.g., older age, black race) and history of prior ED visits for assault and mental health problems predicted increased risk of repeat assault. Conclusions: Previous work may underestimate the rate of repeated assault among adolescents. Adolescents with a history of violence involvement and mental health problems are at elevated risk for repeated assault, and should be targeted for intervention.