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PEDIATRICS Vol. 113 No. 3 March 2004, pp. 530-536

Predictors of Future Fight-Related Injury Among Adolescents

Iris Wagman Borowsky, MD, PhD, Marjorie Ireland, PhD

From the Division of General Pediatrics and Adolescent Health, University of Minnesota, Minneapolis, Minnesota

Objective. Nonfatal fight-related injuries among youths result in lost capacity and high costs of medical care and rehabilitation and constitute a major public health problem. This study identifies factors that predict the occurrence of a fight-related injury that requires medical attention among boys and girls.

Methods. We analyzed data from 14 787 adolescents who completing 2 interviews, approximately 1 year apart, in the National Longitudinal Study of Adolescent Health, a nationally representative, school-based sample of youths. We identified time 1 factors at the community, family, and individual levels that predicted any self-reported fight-related injury that required medical treatment at time 2.

Results. Factors that predict future injury among both boys and girls in multivariate models were violence-related factors: witnessing or being a victim of violence (odds ratio [OR]: 3.69; 95% confidence interval [CI]: 1.81–7.49 for boys; OR: 5.13; 95% CI: 1.25–21.09 for girls), history of a violence-related injury (OR: 2.30; 95% CI: 1.60–3.29 for boys; OR: 3.18; 95% CI: 1.87–5.41 for girls), and physical fighting (OR: 2.02; 95% CI: 1.44–2.84 for boys; OR: 5.15; 95% CI: 3.18–8.34 for girls). Among boys, illicit drug use was also an independent predictor of future injury (OR: 1.72; 95% CI: 1.24–2.37), whereas excellent perceived general health (OR: 0.48; 95% CI: 0.25–0.93) and a high grade point average (OR: 0.52; 95% CI: 0.29–0.95) were significant protective factors against fight-related injury. Girls who reported a high level of depressive symptoms were much more likely to report fight-related injury than nondepressed girls (OR: 8.98; 95% CI: 2.43–33.25).

Conclusions. Factors related to violence, substance use, school achievement, and physical and mental health predicted a future fight-related injury that required medical treatment. The results could assist health and social service providers, educators, and others in identifying youths who are at high risk for fight-related injury and may benefit from appropriate intervention.


Key Words: violence • injury • physical fighting • adolescents • risk factors

Abbreviations: Add Health, National Longitudinal Study of Adolescent Health • RR, relative risk


Received for publication Nov 25, 2002; Accepted Jun 23, 2003.


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