School is a dangerous place to be

January 21, 2014

About 10% of the more than 7 million emergency department visits resulting from injuries sustained at school are the result of intentional injuries and not accidents resulting from sports or other physical activity.

 

About 10% of the more than 7 million emergency department (ED) visits resulting from injuries sustained at school are the result of intentional injuries and not accidents resulting from sports or other physical activity.

To make matters worse, intentional injuries are 5 times as likely to result in hospitalization as unintentional ones.

The findings come from a retrospective cohort study conducted by researchers in Rhode Island.

Using data from the National Electronic Injury Surveillance System during the period from January 1, 2001, to December 31, 2008, the investigators found that an intentional injury at school was 2.33 times as likely to result in a visit to the ED as an intentional injury occurring outside of school. The age group most likely to end up in the ED after an intentional injury at school was middle school-aged students (10- to 14-year-olds). Black students were about 4 times as likely as white students to be sent to the ED after an intentional school injury, followed by Hispanic students (more than 3 times) and American Indians (more than 2 times).

The investigators found that although girls were less likely to sustain an intentional injury resulting in an ED visit at school, they were more likely than boys to sustain an intentional injury outside of school that resulted in an ED visit. This was surprising given that most researchers assume that boys are associated with a higher risk for injury in most settings. The researchers are not sure why the disparity exists.

The top 5 diagnoses in the ED after an intentional injury sustained at school were abrasions/contusions (40%), lacerations (16%), fracture (12%), traumatic brain injury (10%), and strains/sprains (7%). The region of the body most often affected was the head/neck (60%). The intent was almost always assault (96%), and the perpetrator was almost always an acquaintance or friend (86%).

Clearly, the researchers conclude, a need exists for additional interventions to enhance safety at school. For more information and resources, visit the Centers for Disease Control and Prevention website www.cdc.gov/features/safeschools/.


 

 

To get weekly clinical advice for today's pediatrician, subscribe to the Contemporary Pediatrics eConsult.