Hospitalizations for injury in New Zealand: prior injury as a risk factor for assaultive injury.

Abstract

OBJECTIVES. This study sought to determine the degree to which injury hospitalization, especially for assaultive injury, is a risk for subsequent hospitalization due to assault. METHODS. A New Zealand hospitalization database was used to perform a retrospective cohort study. Exposure was defined as an injury hospitalization, stratified into assaultive and nonassaultive mechanisms. Hospitalizations for an assault during a 12-month follow-up period were measured. RESULTS. Individuals with a prior nonassaultive injury were 3.2 times more likely to be admitted for an assault than those with no injury admission (95% confidence interval [CI] = 2.7, 3.9). The relative risk associated with a prior assault was 39.5 (95% CI = 35.8, 43.5), and the subsequent admission rate did not vary significantly by sex, race, or marital or employment status. Among those readmitted for an assault, 70% were readmitted within 30 days of the initial hospitalization. CONCLUSIONS. Prior injury is a risk for serious assault, and the risk is even greater if the injury is due to assault. Risk of readmission for assault is largely independent of demographic factors and greatest within 30 days of the initial assault.

Youth violence secondary prevention initiatives in emergency departments: a systematic review

“…12 Moreover, youth who are injured by violence are at risk of repeat injury due to violence. [6][7][8][9] Given that the ED provides potential for a teachable moment, an opportunity exists for the development of youth violence secondary prevention initiatives in EDs. 11 Four case management interventions reported in 7 articles suggest these programs can reduce future criminal involvement.…”

“…5 Rates of repeat visits for subsequent violence-related injury have been estimated to range from 6% to 44%. [6][7][8][9] A population-based New Zealand study demonstrated that after admission to hospital for an injury due to assault, the risk of future admission to hospital because of a subsequent assault was 39.5 times higher than the risk after admission to hospital for an unintentional injury. Moreover, this second injury was most likely to occur within 30 days of the index injury.…”

“…Moreover, this second injury was most likely to occur within 30 days of the index injury. 6 A US-based study demonstrated that subsequent homicides may be as high as 20% in those who have been injured by violence. 8 Secondary prevention programs are designed for those who have already been affected by violence.…”

Cost−Benefit Analysis Simulation of a Hospital-Based Violence Intervention Program

“…Furthermore, this study focused on violent reinjury at 5-year follow-up and should be considered within the context of research that has assessed violent reinjury at different follow-up periods. [18][19][20][21][22][23][24] The present study highlights the need for a systematic review of the violent reinjury literature. The analysis reported here is based on numerous assumptions and has several limitations.…”

“…7,8 HVIP services are provided by case workers who understand the life experiences of violently injured patients. HVIPs are grounded in empirical data about the recurrent nature of violent injury [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] and the theory that hospitals offer a unique opportunity for intervention. 7,8 HVIPs have shown effectiveness in preventing violent reinjury and perpetration; in improving employment, education, and healthcare utilization; and in reducing aggressive behaviors.…”