A Case for Risk Stratification in Survivors of Firearm and Interpersonal Violence in the Urban Environment

The emergency department (ED) serves as the main source of care for patients who are victimsof interpersonal violence. As a result, emergency physicians across the nation are at the forefrontof delivering care and determining dispositions for many at-risk patients in a dynamic healthcareenvironment. In the majority of cases, survivors of interpersonal violence are treated and dischargedbased on the physical implications of the injury without consideration for risk of reinjury and thestructural drivers that may be at play. Some exceptions may exist at institutions with hospital-basedviolence intervention programs (HVIPs). At these institutions, disposition decisions often includeconsideration of a patient’s risk for repeat exposure to violence. Ideally, HVIP services would beavailable to all survivors of interpersonal violence, but a variety of current constraints limit availability.Here we offer a scoping review of HVIPs and our perspective on how risk-stratification could helpemergency physicians determine which patients will benefit most from HVIP services and potentiallyreduce re-injury secondary to interpersonal violence.