Trauma recidivism in a Canadian province: a 14-year registry review

Abstract

ObjectivesTo determine the rate of recurrent major trauma (i.e., trauma recidivism) using a provincial population-based trauma registry. We compared outcomes between recidivists and non-recidivists, and assessed factors associated with recidivism and mortality.MethodsReview of all adult (>17 years) major trauma patients in Nova Scotia (2001–2015) using data from the Nova Scotia Trauma Registry. Outcomes of interest were mortality, duration of hospital stay, and in-hospital complications. Multiple regression was used to assess factors associated with recidivism and mortality.ResultsOf 9,365 major trauma patients, 2% (150/9365) were recidivists. Mean age at initial injury was 52 ± 21.5 years; 73% were male. The mortality rate for both recidivists and non-recidivists was 31%. However, after adjusting for potential confounders the likelihood of mortality was over 3 times greater for recidivists compared to non-recidivists (OR 3.67, 95% CI 2.06–6.54). Other factors associated with mortality included age, male gender, penetrating injury, Injury Severity Score, trauma team activation (TTA) and admission to the intensive care unit. The only variables associated with recidivism were age (OR 0.98, 95% CI 0.97–1.00) and TTA (OR 0.59, 95% CI 0.34–0.96).ConclusionsThis is the first provincial investigation of major trauma recidivism in Canada. While recidivism was infrequent (2%), the adjusted odds of mortality were over three times greater for recidivists. Further research is warranted to determine the effectiveness of strategies for reducing rates of major trauma recidivism such as screening and brief intervention in cases of violence or substance abuse.

Recidivism at the puerto rico trauma hospital

“…The ISS, GCS, MV requirement, and mortality have been considered questionable due to limited evaluation. Consistent with our ISS results, Caufield et al demonstrated recidivists suffered less severe injuries than non-recidivists, as did Dixon et al and Erdogan et al [ 5 , 8 , 19 ]. Regarding the GCS, our recidivists were less likely to have a severe state.…”

“…Interestingly, the descriptive analysis suggests that a larger proportion of recidivists present at an earlier age, with 40% of cases being reported among the 15–24 age group. This was comparable to findings published by Strong et al, in which 37.3% of recidivists were aged 18–29 years old [ 13 ], distinct from other pieces that identified recidivists to be over 30 years old [ 5 , 10 , 19 ]. Our population of recidivists frequently used public health insurance, contrast to other populations that are predominantly uninsured [ 9 , 12 , 18 ].…”

“…The median time to reinjury for recidivist trauma patients was 42 months. A study of a Canadian recidivist population exhibited an average 41 months to reinjury, which is closest to our marks [19]. Closer to one of the first reinjury analyses, with a median time of 7.9 months, Kaufmann et al demonstrated a median time of approximately 10 months to reinjury [14,21].…”

“…In PRTH, the leading mechanism of injury was MVA, notably among non-recidivists, likewise to other findings throughout the years [ 5 , 8 , 9 , 17 ]. Violence-related injuries overall occurred largely among recidivists, as previously described [ 8 , 19 ]. However, the percentage of violence-related injuries among recidivists in PRTH (44.6%) was considerably higher than the 25% seen by Dixon et al and the 15% documented by Erdogan et al [ 8 , 19 ].…”

“…Violence-related injuries overall occurred largely among recidivists, as previously described [ 8 , 19 ]. However, the percentage of violence-related injuries among recidivists in PRTH (44.6%) was considerably higher than the 25% seen by Dixon et al and the 15% documented by Erdogan et al [ 8 , 19 ]. Furthermore, a previous study revealed recidivist patients were likely to present with the same mechanism of injury in the first and second traumatic events, with rates of up to 75% [ 5 ].…”