Document Type
Article
Publication Date
9-1-2016
Abstract
INTRODUCTION: Although preventing recurrent violent injury is an important component of a public health approach to interpersonal violence and a common focus of violence intervention programs, the true incidence of recurrent violent injury is unknown. Prior studies have reported recurrence rates from 0.8% to 44%, and risk factors for recurrence are not well established.
METHODS: We used a statewide, all-payer database to perform a retrospective cohort study of emergency department visits for injury due to interpersonal violence in Florida, following up patients injured in 2010 for recurrence through 2012. We assessed risk factors for recurrence with multivariable logistic regression and estimated time to recurrence with the Kaplan-Meier method. We tabulated hospital charges and costs for index and recurrent visits.
RESULTS: Of 53 908 patients presenting for violent injury in 2010, 11.1% had a recurrent violent injury during the study period. Trauma centers treated 31.8%, including 55.9% of severe injuries. Among recurrers, 58.9% went to a different hospital for their second injury. Low income, homelessness, Medicaid or uninsurance, and black race were associated with increased odds of recurrence. Patients with visits for mental and behavioral health and unintentional injury also had increased odds of recurrence. Index injuries accounted for $105 million in costs, and recurrent injuries accounted for another $25.3 million.
CONCLUSIONS: Recurrent violent injury is a common and costly phenomenon, and effective violence prevention programs are needed. Prevention must include the nontrauma centers where many patients seek care.
Recommended Citation
Kaufman, Elinore; Rising, MD, MS, Kristin L.; Wiebe, Douglas J.; Ebler, David J.; Crandall, Marie L.; and Delgado, M. Kit, "Recurrent violent injury: magnitude, risk factors, and opportunities for intervention from a statewide analysis." (2016). Department of Emergency Medicine Faculty Papers. Paper 73.
https://jdc.jefferson.edu/emfp/73
PubMed ID
27460511
Language
English
Comments
This article has been peer reviewed. It is the authors' final version prior to publication in American Journal of Emergency Medicine, Volume 34, Issue 9, September 2016, Pages Pages 1823-1830.
The published version is available at https://doi.org/10.1016/j.ajem.2016.06.051 Copyright © Elsevier