Original communication| Volume 113, ISSUE 6, P608-611, June 1993

Trauma is a recurrent disease

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      Background. Many victims of trauma have a history of repetitive accidental or violent injuries, which implies that trauma is not necessarily a random event. Recurrent trauma is thought to be a problem of urban areas, associated with criminal activities, but there are few data from rural areas that include the victims of nonintentional injuries.
      Methods. The prior trauma experience of 200 consecutive patients admitted for trauma was compared with that of 100 consecutive emergency nontrauma surgical admissions and 100 elective surgical admissions to a university hospital and level I trauma center.
      Results. Trauma patients were younger than emergency patients and elective surgery patients. They were more likely to be male than either emergency or elective surgery patients and, along with emergency nontrauma patients, were more likely to be from a racial minority than were elective admissions. Trauma patients were more likely to have had a previous hospitalization for an injury than either emergency patients or elective surgery patients, and a greater proportion of their prior trauma admissions had been within the past 5 years than in the other two groups. There was no difference in the probability of a prior trauma admission between patients admitted with an intentional injury or an accidental injury, but patients whose current admission was for an intentional injury were three times more likely to have had a prior hospitalization as a result of an intentional injury than were patients admitted because of an accidental injury.
      Conclusions. Trauma is a disease with a high risk of recurrence. This may be related to chronic high-risk behaviors such as alcohol or drug abuse, preexisting psychopathology, and cultural acceptance of violent resolution of personal conflicts, all of which adversely affect patients' lives. The role of intensive preventive measures after an initial injury, and directed toward specific high-risk behavior, should be evaluated.
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