Violent and Nonviolent Trauma Patients,Recidivism Mortality: A Comparison

Abstract

Background

Trauma recidivism research and intervention often focuses on violent trauma victims. To identify patients to target for prevention programs, we seek to evaluate if there is a difference in trauma recidivism mortality in patients who have initial nonviolent trauma compared to violent trauma.

Methods

State trauma registry data was queried for patients 13-45 admitted over a 2-year period, followed for 5 years. Unintentional motor vehicle collisions were considered a nonviolent trauma comparator group. Violent trauma included blunt and penetrating mechanisms. Victims of violent trauma (V) were compared to those with nonviolent trauma (NV) with a primary outcome of trauma recidivism mortality.

Results

4406 trauma patients met inclusion criteria with 1470 in the V cohort and 2936 in the NV cohort. In the V cohort, mortality rates were 4.0% from all trauma and 1.5% from violent trauma. In the NV cohort, mortality rates were 3.2% from all trauma and 0.3% from violent trauma. There was no significant difference in trauma recidivism mortality between the V and NV groups (OR 1.3, CI 0.9, 1.7). However, patients initially admitted with a violent trauma mechanism were significantly more likely to die from subsequent violent trauma (OR 4.4, CI 2.1, 9.4).

Discussion

Our study demonstrates that trauma recidivism mortality is high in both violent and nonviolent trauma victims. Those with nonviolent traumas are at similar risk to those with violent traumas of having traumatic deaths within 5 years. This study illustrates an important need to target all cause injury prevention in all trauma patients.