Gender Differences Among Recidivist Trauma Patients

Kwan, Rita O.; Cureton, Elizabeth L.; Dozier, Kristopher C.; Victorino, Gregory P.

doi:10.1016/j.jss.2010.05.060

Cited by 24 publications

(12 citation statements)

References 18 publications

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“…10,27 Female sex, in and of itself, is also associated with a lower risk of repeat injury, with the majority of trauma recidivists being male. 5,28,29 …”

Section: Discussionmentioning

confidence: 99%

“…Limitations included a focus on a single, urban trauma center limiting generalizability, lack of covariates to estimate socioeconomic status such as insurance status or median household income data, and no objective information on mental health comorbidities which have been shown to be associated with trauma recidivism. 28,29,31 In addition, the small number of deaths from specific causes prevented us from examining deaths by injury cause groups, and the high cost of linking to the NDI restricted obtaining additional data. Although the NDI provided extensive long-term mortality data, the outcomes of traumatic injury could be broad and potentially include psychological disability and limited functional status which are not quantified by this study.…”

Section: Discussionmentioning

confidence: 99%

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Trauma Recidivism Predicts Long-term Mortality

2017

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Objectives The objectives of this study were to determine the association between recurrent trauma admissions (recidivism) and subsequent long-term mortality, and to identify those in most need for preventive interventions. Background Patients with a single intentional injury have been shown to have a higher risk of future injury mortality than those with unintentional injury with 5-year mortality rates as high as 20% being reported for recurrent penetrating trauma. Trauma recidivism identifies a high-risk population, but its association with long-term mortality is largely unknown. Methods Patients with 1 or more previous admissions to an urban trauma center (recidivists) were identified and compared with those with single admissions (nonrecidivists) from 1997 to 2008. The trauma registry was linked to the National Death Index to determine both the cause and time to death after hospital discharge. Statistical analysis included chi-square tests, Kaplan-Meier survival curves, and Cox proportional-hazards models. Results Trauma recidivists were 7% of the total trauma population from 1997 to 2008, representing 3147 patients. Recidivists were more likely to be male (P < 0.0001), Black (P < 0.0001), have a blood alcohol content above 80mg/dL (P < 0.0001), and suffer a penetrating injury (P < 0.0001) compared with nonrecidivists. Recidivists with both initial blunt and penetrating injuries had higher rates of long-term mortality after discharge. Recidivists were more likely to die of any cause based on Cox proportional-hazard ratios [hazard ratio (HR) 1.77, 95% confidence interval (CI) 1.57–2.01], injury death (HR 2.02, 95% CI 1.66–2.47), and disease death (HR 1.65, 95% CI 1.41–1.92) than nonrecidivists. Conclusions Male sex, Black race, and elevated blood alcohol content and penetrating injury are associated with trauma recidivism which leads to a higher risk of death. There is a critical public health need to develop interventions to reduce trauma recidivism and preventable death.

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“…10,27 Female sex, in and of itself, is also associated with a lower risk of repeat injury, with the majority of trauma recidivists being male. 5,28,29 …”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Trauma Recidivism Predicts Long-term Mortality

2017

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“…One study (Toschlog et al 2007 ) found females to be more likely than males to have recurrent injuries while the opposite was found by other studies (Caufeild et al 2004 ; McCoy et al 2013 ; Toschlog et al 2007 ; Worrell et al 2006 ). For the most part, data limitations hinder the ability to provide comprehensive evidence because most studies used registries collected at a single hospital (Davis et al 2013 ; Dixon et al 2014 ; Kondo et al 2011 ; Kwan et al 2011 ; McCoy et al 2013 ). It is not unlikely that patients sustaining a recurrent injury may go to a different provider or choose not seek medical care either due to access factors, negative experience with providers or lower severity of later injuries.…”

Section: Introductionmentioning

confidence: 99%

Longitudinal assessment of injury recidivism among adults in the United States: findings from a population-based sample

2016

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BackgroundRepeated injuries, as known as injury recidivism, pose a significant burden on population health and healthcare settings. Therefore, identifying those at risk of recidivism can highlight targeted populations for primary prevention in order to improve health and reduce healthcare expenditures. There has been limited research on factors associated with recidivism in the U.S. Using a population-based sample, we aim to: 1) identify the prevalence and risk factors for injury recidivism among non-institutionalized adults; 2) investigate the trend in nationwide recidivism rates over time.MethodsUsing the Medical Expenditure Panel Survey (MEPS), 19,134 adults with at least one reported injury were followed for about 2 years. Reported injuries were those associated with healthcare utilization, disability days or any effects on self-reported health. The independent associations between risk factors for recidivism were evaluated incorporating a weighted logistic regression model.ResultsThere were 4,136 recidivists representing over nine million individuals in the U.S. over a 2-year follow-up. About 44 % of recidivists sustained severe injuries requiring a hospitalization, a physician’s office visit or an emergency department visit. Compared with those who sustained a single injury, recidivists were more likely to be white, unmarried, reside in metropolitan areas, and report a higher prevalence of chronic conditions. Age, sex, race/ethnicity, marital status, urbanicity, region, diabetes, stroke, asthma and depression symptoms were significant predictors of recidivism. Significant interaction effects between age and gender suggested those in the 18–25 age group, the odds of being a recidivist were 1.45 higher among males than females adjusting for other covariates. While having positive screens for depression in both follow-up years was associated with 1.46 (95 % CI = 1.21–1.77) higher odds of recidivisms than the reference group adjusting for other variables.ConclusionsWe observed a higher recidivism rate among injured individuals in this study than previously reported. Our findings emphasize the pressing need for injury prevention to reduce the burden of repeated injuries. Preventative efforts may benefit from focusing on males between 18 and 25 years of age and those with comorbidities such as diabetes, stroke and depression.

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“…Despite many of the young men being classified as IRs because they had received traumatic injuries caused by modern weapons, motor vehicles, and falls, these studies found that they were more likely to be injured during an assault compared to non-repeat patients, because of their life-style choices (Hedges et al, 1995). Females were not immune to injuries from assault, but were typically victims rather than perpetrators of assault and/or intimate partner violence compared to their male peers, although there were exceptions (Kwan et al, 2011). A small number of USA studies confirmed that in rural settings, recidivists were also most likely to be young adult males (Toschlog et al, 2007;Williams et al, 1997).…”

Section: Introductionmentioning

confidence: 99%

Multiple Injury and Health in Past Societies: An Analysis of Concepts and Approaches, and Insights from a Multi‐Period Study

Redfern

Judd

DeWitte

2016

Intl J of Osteoarchaeology

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Earlier clinical and bioarchaeological studies found that injury recidivists were most likely to be young adult males. Since then, the clinical meaning of the injury recidivist has expanded to include all individuals with multiple injuries, and other aspects of health have been considered. Our study sought to apply these advances to paleopathology and place multiple injuries in a wider context by investigating: the age and sex distribution of those with single and multiple fractures, and if people with multiple injuries had poorer general health. The sample of 213 males and 190 females (≥18 years old) from six populations in England, Siberia, and Sudan ranged in date from the 3rd century BC to the mid‐19th century AD. Health variables included cribra orbitalia, porotic hyperostosis, periostitis, Schmorl's nodes, enamel hypoplasias, dental caries, and periodontitis. Ante‐mortem injuries were: fractures (0/1/≥2), myositis ossificans, dental trauma, and sharp‐force injuries. The data were analysed using chi‐square and hierarchical loglinear analyses (P = 0.05). No significant three‐way association between age, sex, and injury was found. There was no difference between the sexes when individuals with single versus multiple injuries were compared. There were significant differences in the age‐distribution of people with 0 and 1/≥2 fractures. Males and those 26–35 years old were most likely to have fractures and multiple injuries. Porotic hyperostosis was significantly associated with fractures. There was no significant relationship between general poor health and multiple injuries. Copyright © 2016 John Wiley & Sons, Ltd.

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Gender Differences Among Recidivist Trauma Patients

Cited by 24 publications

References 18 publications

Trauma Recidivism Predicts Long-term Mortality

Trauma Recidivism Predicts Long-term Mortality

Longitudinal assessment of injury recidivism among adults in the United States: findings from a population-based sample

Multiple Injury and Health in Past Societies: An Analysis of Concepts and Approaches, and Insights from a Multi‐Period Study

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