J. Zebley1, M. T. Quintana1, S. Bornstein1, J. Estroff1, R. Amdur1, R. Burd2, E. McKenna2, E. Hall3, C. Trankiem3, M. Williams4, A. Zeineddin4, B. Sarani1 1George Washington University School Of Medicine And Health Sciences, Surgery, Washington, DC, USA 2Children’s National Medical Center, Washington, DC, USA 3Washington Hospital Center, Washington, DC, USA 4Howard University College Of Medicine, Washington, DC, USA
Introduction:
It is generally assumed that patients who sustain one type of violent trauma are at risk for sustaining another type. We aim to determine the incidence of and risk factors for recidivism following violent injury. We hypothesize that being the victim of violent injury is a risk factor for subsequent violent trauma.
Methods:
We performed a retrospective, multicenter review of patients who sustained blunt assault or penetrating trauma from January 2013 to December 2019 in Washington, DC. Recidivism was defined as the ratio of readmitted patients among those who survived a previous admission. Univariate associations between each readmission and age, sex, mechanism of injury, AIS, ISS, treatment hospital, and discharge disposition were determined. Kaplan-Meier curves were plotted to evaluate the incidence of recidivism over time. A multivariable Cox proportional hazard model was used to examine the association between characteristics at first admission and time-to-readmission.
Results:
The recidivism rate in 13,211 patients was 6.3% (Table 1). 714 patients had 1 re-admission (5.4%), and 122 patients had 2 re-admissions (0.9%). Patients aged 14-30 or 31-45 years had the highest incidences of recidivism (p<0.001). Injury type (blunt vs penetrating) was not associated with readmission, but patients were more likely to be re-injured by the same MOI at a subsequent admission. Risk factors for readmission on multivariate analysis were head AIS >/= 3, male sex, and discharge against medical advice or to jail. Discharge to nursing facility had a negative association with recidivism.
Conclusion:
Although it is assumed that once a patient is a victim of violence, they are at risk of falling victim to violent trauma again, incidence of recidivism was found to be relatively low. Despite this, victims of violence aged 14-45 remain an important target population for future violence prevention measures.
