Patterns and outcomes among penetrating trauma recidivists: It only gets worse

Benjamin S. Brooke, David Thomas Efron, David C. Chang, Elliott Haut, Edward E. Cornwell

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Trauma recidivism accounts for a significant proportion of visits to urban trauma centers. The current study was designed to characterize injury patterns among individual recidivists and analyze their impact on mortality. METHODS: Recidivists were identified within a trauma registry from an urban level-one trauma center from a period between 1997 and 2004. Demographic, injury type, and final disposition data were retrospectively reviewed. The primary outcomes measured were all-cause mortality and injury mechanism. The data were analyzed using the χ method, and logistic regression analysis. RESULTS: Among 15,973 total trauma visits, 2,511 (15.7%) were by recidivists, representing 1,528 unique patients. Of these recidivists, 794 (52%) had their first trauma admission during the period reviewed (84% male, 87% African-American, mean age 31 ± 13 years). Blunt injuries only were identified in 43.8% patients, while 21.9% had penetrating injuries only, and 34.3% had a combination of injury patterns. Recidivists presenting with penetrating trauma as their initial injury were more likely to return with penetrating injuries on their second (58% vs. 25% [p < 0.001]) and third (68% vs. 24% [p < 0.001]) visits. The all-cause mortality of a penetrating injury was significantly higher than that of a blunt injury for both second (9.2% vs. 1.0% [p < 0.001]) and third (15.1% vs. 1.3% [p = 0.002]) visits. The likelihood of mortality increased over twofold for each subsequent penetrating trauma visit (odds ratio [OR]; 95% confidence interval [CI]; 2.20 [1.63-2.97], p < 0.001). CONCLUSIONS: Individual recidivists with penetrating injuries are likely to return with the same injury pattern, and are at increased risk of death with each subsequent visit.

Original languageEnglish (US)
Pages (from-to)16-19
Number of pages4
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume61
Issue number1
DOIs
StatePublished - Jul 1 2006

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Wounds and Injuries
Nonpenetrating Wounds
Mortality
Trauma Centers
African Americans
Registries
Logistic Models
Odds Ratio
Regression Analysis
Demography
Confidence Intervals

Keywords

  • Mortality
  • Outcomes
  • Penetrating trauma
  • Recidivism
  • Trauma patients

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine

Cite this

Patterns and outcomes among penetrating trauma recidivists : It only gets worse. / Brooke, Benjamin S.; Efron, David Thomas; Chang, David C.; Haut, Elliott; Cornwell, Edward E.

In: Journal of Trauma - Injury, Infection and Critical Care, Vol. 61, No. 1, 01.07.2006, p. 16-19.

Research output: Contribution to journalArticle

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abstract = "BACKGROUND: Trauma recidivism accounts for a significant proportion of visits to urban trauma centers. The current study was designed to characterize injury patterns among individual recidivists and analyze their impact on mortality. METHODS: Recidivists were identified within a trauma registry from an urban level-one trauma center from a period between 1997 and 2004. Demographic, injury type, and final disposition data were retrospectively reviewed. The primary outcomes measured were all-cause mortality and injury mechanism. The data were analyzed using the χ method, and logistic regression analysis. RESULTS: Among 15,973 total trauma visits, 2,511 (15.7{\%}) were by recidivists, representing 1,528 unique patients. Of these recidivists, 794 (52{\%}) had their first trauma admission during the period reviewed (84{\%} male, 87{\%} African-American, mean age 31 ± 13 years). Blunt injuries only were identified in 43.8{\%} patients, while 21.9{\%} had penetrating injuries only, and 34.3{\%} had a combination of injury patterns. Recidivists presenting with penetrating trauma as their initial injury were more likely to return with penetrating injuries on their second (58{\%} vs. 25{\%} [p < 0.001]) and third (68{\%} vs. 24{\%} [p < 0.001]) visits. The all-cause mortality of a penetrating injury was significantly higher than that of a blunt injury for both second (9.2{\%} vs. 1.0{\%} [p < 0.001]) and third (15.1{\%} vs. 1.3{\%} [p = 0.002]) visits. The likelihood of mortality increased over twofold for each subsequent penetrating trauma visit (odds ratio [OR]; 95{\%} confidence interval [CI]; 2.20 [1.63-2.97], p < 0.001). CONCLUSIONS: Individual recidivists with penetrating injuries are likely to return with the same injury pattern, and are at increased risk of death with each subsequent visit.",
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AU - Cornwell, Edward E.

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N2 - BACKGROUND: Trauma recidivism accounts for a significant proportion of visits to urban trauma centers. The current study was designed to characterize injury patterns among individual recidivists and analyze their impact on mortality. METHODS: Recidivists were identified within a trauma registry from an urban level-one trauma center from a period between 1997 and 2004. Demographic, injury type, and final disposition data were retrospectively reviewed. The primary outcomes measured were all-cause mortality and injury mechanism. The data were analyzed using the χ method, and logistic regression analysis. RESULTS: Among 15,973 total trauma visits, 2,511 (15.7%) were by recidivists, representing 1,528 unique patients. Of these recidivists, 794 (52%) had their first trauma admission during the period reviewed (84% male, 87% African-American, mean age 31 ± 13 years). Blunt injuries only were identified in 43.8% patients, while 21.9% had penetrating injuries only, and 34.3% had a combination of injury patterns. Recidivists presenting with penetrating trauma as their initial injury were more likely to return with penetrating injuries on their second (58% vs. 25% [p < 0.001]) and third (68% vs. 24% [p < 0.001]) visits. The all-cause mortality of a penetrating injury was significantly higher than that of a blunt injury for both second (9.2% vs. 1.0% [p < 0.001]) and third (15.1% vs. 1.3% [p = 0.002]) visits. The likelihood of mortality increased over twofold for each subsequent penetrating trauma visit (odds ratio [OR]; 95% confidence interval [CI]; 2.20 [1.63-2.97], p < 0.001). CONCLUSIONS: Individual recidivists with penetrating injuries are likely to return with the same injury pattern, and are at increased risk of death with each subsequent visit.

AB - BACKGROUND: Trauma recidivism accounts for a significant proportion of visits to urban trauma centers. The current study was designed to characterize injury patterns among individual recidivists and analyze their impact on mortality. METHODS: Recidivists were identified within a trauma registry from an urban level-one trauma center from a period between 1997 and 2004. Demographic, injury type, and final disposition data were retrospectively reviewed. The primary outcomes measured were all-cause mortality and injury mechanism. The data were analyzed using the χ method, and logistic regression analysis. RESULTS: Among 15,973 total trauma visits, 2,511 (15.7%) were by recidivists, representing 1,528 unique patients. Of these recidivists, 794 (52%) had their first trauma admission during the period reviewed (84% male, 87% African-American, mean age 31 ± 13 years). Blunt injuries only were identified in 43.8% patients, while 21.9% had penetrating injuries only, and 34.3% had a combination of injury patterns. Recidivists presenting with penetrating trauma as their initial injury were more likely to return with penetrating injuries on their second (58% vs. 25% [p < 0.001]) and third (68% vs. 24% [p < 0.001]) visits. The all-cause mortality of a penetrating injury was significantly higher than that of a blunt injury for both second (9.2% vs. 1.0% [p < 0.001]) and third (15.1% vs. 1.3% [p = 0.002]) visits. The likelihood of mortality increased over twofold for each subsequent penetrating trauma visit (odds ratio [OR]; 95% confidence interval [CI]; 2.20 [1.63-2.97], p < 0.001). CONCLUSIONS: Individual recidivists with penetrating injuries are likely to return with the same injury pattern, and are at increased risk of death with each subsequent visit.

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KW - Trauma patients

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