According to a study published online on August 15, emergency department use among adolescents is high before and after self-inflicted injuries. JAMA network opened.

Samaa Kemal, MD, MPH, of Northwestern University Feinberg School of Medicine in Chicago, and colleagues conducted a retrospective cohort study of emergency department encounters of adolescents ages 5 to 18 years with self-inflicted injuries to examine emergency department use 90 days before and 90 days after the self-inflicted injury.

A total of 15,593 emergency department encounters by adolescents (mean age, 15 years) were identified and included in the analysis. The researchers found that 24.2 percent of adolescents had an emergency department encounter within 90 days before an index injury; 71.8 percent of these occurred in general emergency department settings and 38.2 percent were for mental health or behavioral issues.

Adolescents with statutory health insurance and those living in rural areas had a higher adjusted probability of being treated in the emergency department within 90 days before an index visit (adjusted odds ratio: 1.77 and 1.31, respectively).

Overall, 26.7 percent of adolescents had an emergency department visit within 90 days of an index injury; 69.2 percent occurred in general emergency departments, and 47.9 percent were for mental health or psychological issues. Higher odds of an emergency department visit within 90 days of an index visit were observed among those with public health insurance, in rural areas, and in small towns (adjusted odds ratios 1.72, 1.21, and 1.29, respectively).

“We found that adolescents are frequent ED users before and after self-inflicted injury,” the authors write. “This finding suggests the opportunity for ED-based interventions, such as suicide risk screening, safety planning, and linkage to services.”

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