Emergency department visits resulting from intentional injury in and out of school

BACKGROUND AND OBJECTIVE: Previous studies have reported concerning numbers of injuries to children in the school setting. The objective was to understand temporal and demographic trends in intentional injuries in the school setting and to compare these with intentional injuries outside the school setting. METHODS: Data from the National Electronic Injury Surveillance System-All Injury Program from 2001 to 2008 were analyzed to assess emergency department visits (EDVs) after an intentional injury. RESULTS: There were an estimated 7 397 301 total EDVs due to injuries sustained at school from 2001 to 2008. Of these, an estimated 736 014 (10%) were reported as intentional (range: 8.5%-10.7% for the study time period). The overall risk of an EDV after an intentional injury in school was 2.33 (95% confidence interval [CI]: 1.93-2.82) when compared with an EDV after an intentional injury outside the school setting. For intentional injury-related EDVs originating in the school setting, multivariate regression identified several demographic risk factors: 10- to 14-year-old (odds ratio [OR]: 1.58; 95% CI: 1.10-2.27) and 15- to 19-year-old (OR: 1.69; 95% CI: 1.01-2.82) age group, black (OR: 4.14; 95% CI: 2.94-5.83) and American Indian (OR: 2.48; 95% CI: 2.06-2.99) race, and Hispanic ethnicity (OR: 3.67; 95% CI: 2.02-6.69). The odds of hospitalization resulting from intentional injury-related EDV compared with unintentional injury-related EDVs was 2.01 (95% CI: 1.50-2.69) in the school setting. These odds were found to be 5.85 (95% CI: 4.76-7.19) in the outside school setting. CONCLUSIONS: The findings of this study suggest a need for additional prevention strategies addressing school-based intentional injuries.