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Abstract
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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References
- Statistical abstract of the United States: 1990.in: 110th ed. 1990 (Washington, DC)
- Presidential address: on the nature of things that go bang in the night.Surgery. 1982; 92: 123-132
- 2nd ed. Cost of injury in the United States: a report to Congress. Institute for Health & Aging, University of California and Injury Prevention Center, The Johns Hopkins University, San Francisco1989
- Urban trauma: a chronic recurrent disease.J Trauma. 1989; 29: 940-947
- Trauma recidivism.Am Surg. 1990; 56: 556-560
Vital Statistics of Mississippi 1960–1990. Jackson: Mississippi State Department of Health.
- Marijuana and alcohol use among 1023 trauma patients: a prospective study.Arch Surg. 1988; 123: 733-737
- Pattern of alcohol and drug abuse in an urban trauma center: the increasing role of cocaine abuse.J Trauma. 1989; 29: 1654-1658
- Characteristics of blunt and personal violent injuries.J Trauma. 1990; 30: 176-182
- Preinjury psychopathology in trauma patients.J Trauma. 1989; 29: 1158-1162
Article info
Publication history
Accepted:
March 17,
1992
Footnotes
☆Presented at the Fourteenth R. Adams Cowley National Trauma Symposium, Baltimore, Md., March 7, 1992.
Identification
Copyright
© 1993 Published by Elsevier Inc.
