Citation

Maung AA, Becher RD, Schuster KM, Davis KA. Trauma Surg. Acute Care Open 2018; 3(1): e000181.

Affiliation

Department of Surgery, Section of General Surgery, Trauma and Surgical Critical Care, Yale School of Medicine, New Haven, Connecticut, USA.

Copyright

(Copyright © 2018, The author(s) and the American Association for the Surgery of Trauma, Publisher BMJ Publishing Group)

DOI

10.1136/tsaco-2018-000181

PMID

29766143

PMCID

PMC5905833

Abstract

BACKGROUND: Care of patients with trauma is not only limited to the sustained physical injuries but also requires addressing social issues, such as substance abuse and interpersonal violence, which are responsible for trauma-related recidivism. This study investigates whether there are age-related variations in these problematic social behaviors to analyze whether there is an age cut-off at which point adolescents should be screened for adult social behaviors.

METHODS: Retrospective review of patients with trauma aged 12-21 admitted to an urban Level 1 adult and pediatric trauma center between February 2013 and April 2016. Demographics, mechanisms of injury, Injury Severity Score, outcomes, toxicology and social history evaluations were abstracted from the electronic medical record.

RESULTS: 756 patients were admitted during the 39-month period. Most patients were male (73.9%) without significant variation by age. The mechanisms of injury varied by age (p<0.001) with the incidence of sports and bicycle injuries decreasing and the incidence of motor vehicle/motorcycle crashes, assaults and gunshot injuries increasing with increasing patient age. In a logistic regression, risks of positive toxicology tests, injuries due to violence as well as overall use of drugs, tobacco and alcohol also significantly increased with age starting with the youngest age included in the study.

CONCLUSIONS: As pediatric trauma patients get older, they have increasing risks of social issues typically associated with adults. Our study underscores the need to evaluate and address these issues even in young adolescents. LEVEL OF EVIDENCE: Level IV-epidemiological.

Language: en

Keywords

alcohol abuse; injury prevention; pediatric trauma; recidivism; substance abuse