LAUSR

Aims Within an inner city borough the Child Death Overview Panel recognised an increase in deaths associated with violent youth crime, with 4 reported deaths between September 2015 and August 2016. It was unclear whether this represented a wider problem concerning violent youth crime within the local community. This study sought to investigate recent trends in youth attendances to the local Emergency Department (ED) related to violent crime. Methods We conducted a single-centre retrospective observational study of all youth (<18 years) attendances to the ED of a large district general hospital, over 4 years (November 2012 – September 2016) with injuries associated with violent crime. Cases were filtered using key word search of the triage description, diagnosis field or free text fields using words associated with violent crime. Files were then manually reviewed by the authors to select relevant cases. Results During the 4 year study period there were 122 ED presentations associated with violent youth crime. The average age was 14.9 years and the majority male (70.5%, n=86). During the study period the number of presentations increased from 26 in the 1 st half of the study period to 96 in the 2nd half. There was a significant increase in the proportion of cases involving female patients, from 7.7% (2/26) in the first half of the study period to 35.4% (34/96) in the 2nd half (p=0.007). A number of vulnerability factors were also frequently seen within the cohort, including past involvement of children’s social care or CAMHS, a history of school exclusion or referral to pupil referral units, and a diagnosis of ADHD, Autism or cognitive delay. Conclusion This study demonstrates an increase in local youth ED attendances with injuries related to violent crime, with rising numbers of female attendees over the last 2 years. This data was presented to stakeholders including representatives from Public Health, ED, the local MP and the charity sector. An application has been made for funding from the local mayor for an ED based youth worker.