{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T13:53:57Z","timestamp":1791986037680,"version":"4.4.0"},"reference-count":15,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Trauma Surg Acute Care Open"],"accepted":{"date-parts":[[2018,3,21]]},"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>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.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Retrospective review of patients with trauma aged 12\u201321 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.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>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&lt;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.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>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.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Level of evidence<\/jats:title>\n                  <jats:p>Level IV\u2014epidemiological.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/tsaco-2018-000181","type":"journal-article","created":{"date-parts":[[2018,4,9]],"date-time":"2018-04-09T10:35:10Z","timestamp":1523270110000},"page":"e000181","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["When should screening of pediatric trauma patients for adult behaviors start?"],"prefix":"10.1136","volume":"3","author":[{"given":"Adrian A","family":"Maung","sequence":"first","affiliation":[{"name":"Department of Surgery, Section of General Surgery, Trauma and Surgical Critical Care, Yale School of Medicine, New Haven, Connecticut, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert D","family":"Becher","sequence":"additional","affiliation":[{"name":"Department of Surgery, Section of General Surgery, Trauma and Surgical Critical Care, Yale School of Medicine, New Haven, Connecticut, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin M","family":"Schuster","sequence":"additional","affiliation":[{"name":"Department of Surgery, Section of General Surgery, Trauma and Surgical Critical Care, Yale School of Medicine, New Haven, Connecticut, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberly A","family":"Davis","sequence":"additional","affiliation":[{"name":"Department of Surgery, Section of General Surgery, Trauma and Surgical Critical Care, Yale School of Medicine, New Haven, Connecticut, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,4,9]]},"reference":[{"key":"2025082410435349000_3.1.e000181.1","doi-asserted-by":"crossref","first-page":"961","DOI":"10.1097\/TA.0000000000001222","article-title":"The effects of health care-based violence intervention programs on injury recidivism and costs: a systematic review","volume":"81","author":"Strong","year":"2016","journal-title":"J Trauma Acute Care Surg"},{"key":"2025082410435349000_3.1.e000181.2","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1097\/NNR.0000000000000231","article-title":"Alcohol or drug use and trauma recidivism","volume":"66","author":"Cordovilla-Guardia","year":"2017","journal-title":"Nurs Res"},{"key":"2025082410435349000_3.1.e000181.3","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1016\/j.injury.2016.01.008","article-title":"The prevalence of alcohol-related trauma recidivism: a systematic review","volume":"47","author":"Nunn","year":"2016","journal-title":"Injury"},{"key":"2025082410435349000_3.1.e000181.4","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0182441","article-title":"Effect of a brief intervention for alcohol and illicit drug use on trauma recidivism in a cohort of trauma patients","volume":"12","author":"Cordovilla-Guardia","year":"2017","journal-title":"PLoS One"},{"key":"2025082410435349000_3.1.e000181.5","unstructured":"COT ACS. Resources for optimal care of the injured patient. 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Average for United States 2006\u20132010 Alcohol-Attributable Deaths Due to Excessive Alcohol Use. 2017 https:\/\/nccd.cdc.gov\/DPH_ARDI\/Default\/Report.aspx?T=AAM&P=f6d7eda7-036e-4553-9968-9b17ffad620e&R=d7a9b303-48e9-4440-bf47-070a4827e1fd&M=8E1C5233-5640-4EE8-9247-1ECA7DA325B9&F=&D= (accessed 12 Dec 2017)."},{"key":"2025082410435349000_3.1.e000181.15","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2015-1260"}],"container-title":["Trauma Surgery &amp; Acute Care Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/tsaco-2018-000181","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,24]],"date-time":"2025-08-24T17:44:06Z","timestamp":1756057446000},"score":1,"resource":{"primary":{"URL":"https:\/\/tsaco.bmj.com\/lookup\/doi\/10.1136\/tsaco-2018-000181"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,4]]},"references-count":15,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2018,4,9]]},"published-print":{"date-parts":[[2018,4]]}},"alternative-id":["10.1136\/tsaco-2018-000181"],"URL":"https:\/\/doi.org\/10.1136\/tsaco-2018-000181","relation":{},"ISSN":["2397-5776"],"issn-type":[{"value":"2397-5776","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,4]]}}}