A multicenter, citywide report on recurrent violent injury

Authors

Megan Quintana, Department of Surgery, Center for Trauma and Critical Care, George Washington University, 2150 Pennsylvania Ave, NW, Suite 6B, Washington, DC 20037, USA.
Sydney Bornstein, Department of Surgery, Center for Trauma and Critical Care, George Washington University, 2150 Pennsylvania Ave, NW, Suite 6B, Washington, DC 20037, USA.
Catherine Zwemer, Department of Surgery, Center for Trauma and Critical Care, George Washington University, 2150 Pennsylvania Ave, NW, Suite 6B, Washington, DC 20037, USA.
James A. Zebley, Department of Surgery, Center for Trauma and Critical Care, George Washington University, 2150 Pennsylvania Ave, NW, Suite 6B, Washington, DC 20037, USA.
Richard Amdur, Department of Surgery, Center for Trauma and Critical Care, George Washington University, 2150 Pennsylvania Ave, NW, Suite 6B, Washington, DC 20037, USA.
Christine T. Trankiem, Division of Trauma, Department of Surgery, MedStar Washington Hospital Center, Washington, DC, USA.
Randall S. Burd, Department of Pediatric Surgery, Children's National Medical Center, Washington, DC, USA.
Elise McKenna, Department of Pediatric Surgery, Children's National Medical Center, Washington, DC, USA.
Mallory Williams, Department of Surgery, Howard University Hospital, Washington, DC, USA.
Babak Sarani, Department of Surgery, Center for Trauma and Critical Care, George Washington University, 2150 Pennsylvania Ave, NW, Suite 6B, Washington, DC 20037, USA. Electronic address: bsarani@mfa.gwu.edu.

Document Type

Journal Article

Publication Date

3-12-2023

Journal

Injury

DOI

10.1016/j.injury.2023.03.005

Keywords

Injury prevention; Recidivism; Recurrent injury; Trauma; Violence

Abstract

INTRODUCTION: The incidence of and risk factors for recurrent violent trauma are not well known. This information is needed to focus violence prevention efforts on at-risk cohorts. The purpose of this study was to determine the incidence of and risk factors for recurrence following violent injury in a large urban setting. We hypothesize that the overall incidence of recurrent violent injury is low but there are specific at-risk cohorts. METHODS: A retrospective, citywide study of patients who sustained blunt assault or penetrating trauma from 2013 to 2019 was performed. Patients were tracked across all trauma centers using their name and date of birth. The primary outcome was incidence of recurrent violent injury, which was calculated by dividing the number of readmitted patients by the number who survived previous admissions due to penetrating trauma or blunt assault. Associations between readmission and injury severity score, abbreviated injury score, age, sex, hospital, mechanism of injury (MOI), and disposition were determined. Kaplan-Meier curves were plotted to determine the incidence of recurrent injury over time. A multivariable Cox proportional hazard model was used to examine the relationships between characteristics at first admission and time-to-readmission. RESULTS: The recurrent injury rate was 836 patients (6.33%) out of 13,211 injured patients. Male, age 14-45 years old, discharge to jail or left against medical advice, and moderate/severe head injury were associated with re-injury. There was no association between recurrence and mechanism of injury or overall injury severity. Discharge to home was associated with a lower re-injury rate. CONCLUSION: The low recurrent injury rate despite high injury prevalence suggests injury prevention efforts should target this demographic and their non-injured peers.

APA Citation

Quintana, Megan; Bornstein, Sydney; Zwemer, Catherine; Zebley, James A.; Amdur, Richard; Trankiem, Christine T.; Burd, Randall S.; McKenna, Elise; Williams, Mallory; and Sarani, Babak, "A multicenter, citywide report on recurrent violent injury" (2023). GW Authored Works. Paper 2595.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/2595

Department

Surgery