Author	A. Herbert
Author	L. Li
Author	R. Gilbert
Author	A. Gonzalez-Izquierdo
URL	https://www.researchgate.net/profile/Annie_Herbert
Abstract	Background: Information is lacking on the risks of future harm for adolescents hospitalised in England as an emergency with adversity-related injury (violent, self-inflicted, drug/alcohol-related). Evidence is needed on who is most at risk and the types of harm, to inform preventive strategies. Methods: Using Hospital Episode Statistics linked to Office for National Statistics mortality data for England (April 1997-March 2012), I estimated the prevalence of emergency admissions for adversity-related injury among 10-19y olds, and identified risk factors. I examined the risks of death and emergency re-admission after discharge from adversity-related injury, compared with after accident-related injury. Results: 1 in 25 adolescents had an emergency admission for adversity-related injury between the ages of 10 and 19y. Among these adolescents, 73% of girls and 38% of boys were admitted with more than one type (e.g., self-inflicted and drug/alcohol-related). In addition, 1/137 girls and 1/64 boys with adversity-related injury died within ten years after discharge; 54% of girls and 41% of boys were re-admitted as an emergency. These risks were approximately double those following accident-related injury, regardless of whether violent, self-inflicted or drug/alcohol-related, and were particularly high for older boys and adolescents with chronic conditions. Increased risks of death were mostly explained by suicide and drug/alcohol-related deaths. After each type of adversity-related injury, risks of drug/alcohol-related deaths were similar to those of suicide deaths. Conclusions: 1 in 25 adolescents in England were admitted as an emergency to hospital for adversity-related injury, often with multiple types of adversity-related injury, and were at considerable risks of harm in the next decade compared to other adolescents. Current strategies to reduce risks after self-inflicted injury in this group should be extended to violent and drug/alcohol-related injury. Strategies could include targeting older adolescents with chronic conditions, and prioritising risks of drug/alcohol-related death alongside those of suicide death.