K. Barrera2, L. Lajoie2, A. Chudner2, D. Solomon2, V. Roudnitsky1, T. Schwartz1 1Kings County Hospital Center,Acute Care Surgery,Brooklyn, NY, USA 2SUNY Downstate,Department Of Surgery,Brooklyn, NY, USA
Introduction:
Recurrent violent injury (RVI) has been a topic of interest in trauma with recent reported rates greater than 30%. There has been specific focus on prevention, with many trauma centers implementing violence prevention programs aimed at youth. In these programs, patients are followed by case workers after discharge. Outcomes have been favorable with a trend towards reduction of recurrent injury as well as crime. Although there are several programs that include victims of injury of all ages, several programs target ages 10-30 years as recidivism is more prevalent in youths. The purpose of this study is to examine the differences between younger versus older recidivists to determine if adult recidivists may also benefit from efforts to reduce recidivism.
Methods:
This is a retrospective cohort study of all patients ages 15-60 seen by the trauma team at a single urban trauma center for violent injuries over a six year period. Patients were followed for recurrent injury for a minimum 3 years. Patients that died after first violent injury were excluded. Data collection also included mechanism of injury. Chi-square test, and T Test were used to determine differences in characteristics of recidivism between 15-25 and 25-60 age groups.
Results:
A total of 2642 patients were included in the analysis. This group was further subdivided into two age groups, 15-25 years (n=1300) and 26-60 years (1342). Overall recidivism rate was 11%. In the youth group, recidivism rate was 14% versus 9% in adults (p<0.001). Amongst the youth group, injuries inflicted by gunshot wounds, stab wounds and blunt assault comprised of 35%, 36%, and 29% of injuries respectively. In the adult group, this was 28%, 34%, and 38% respectively. There were no statistically significant differences between mechanisms of injury between the youth and adult groups. There was no significant difference in mean time to recurrence which was 66 months in youths and 62 months in adults (p=0.8). Mean abbreivated injury severity score was 4.8 in youths and 6.1 in adults and was not statistically significant.
Conclusion:
Violent injury prevention programs have focused on at risk youth as typically recidivism is significantly more prominent in this population. Despite a lower recidivism rate in an adult population, the prevalence is substantial. Adults experience similar current injuries when compared to youth in a similar time frame with a similar degree of injury. In urban trauma centers, violent injury prevention programs addressing an adult population may be beneficial in reduction of recurrent violent injury.