Recidivism at the puerto rico trauma hospital

Abstract

Purpose Although trauma represents a leading cause of morbidity and mortality worldwide, there is limited and heterogeneous evidence regarding trauma recidivism and its outcomes. This analysis determined the rate and independent risk factors of trauma recidivism and compared the first and second injury episode among recidivists. Methods An IRB-approved retrospective cohort study was performed with data from the Puerto Rico Trauma Hospital Registry. Bivariate analyses were done using Pearson’s Chi squared, Wilcoxon rank-sum, McNemar, Stuart-Maxwell or Wilcoxon signed-rank tests, as appropriate. Independent predictors for recidivism were determined through a logistic regression model. Statistical significance was set at p < 0.05. Results 24,650 patients were admitted to the hospital during 2000–2017. Recidivism rate was 14 per 1,000 patients discharged alive. Males and individuals aged 15–24 years old were 3.88 (95% CI: 2.21–6.80) and 3.80 (95% CI: 2.24–6.46) times more likely to be recidivists, respectively. Contrariwise, an ISS $$\ge$$ ≥ 25 [adjusted odds ratio (AOR) = 0.44; 95% CI: 0.28–0.68] and a GCS $$\le$$ ≤ 8 (AOR = 0.56; 95% CI 0.34–0.92) were protective factors. Furthermore, recidivists exhibited less in-hospital mortality than their non-recidivist counterparts (7.2% vs. 10.7%; p = 0.045). For recidivists, the median (interquartile range) time to reinjury was 42 (59) months; and the second injury episode was more severe than the first one, as the proportion of patients with ISS $$\ge$$ ≥ 25 increased (7.9% vs. 14.1%; p = 0.022). Conclusion The independent predictors of trauma recidivism and the median time to reinjury identified in this study provide valuable information to the development of prevention strategies aimed at reducing the burden of injury.

Effects of prior injury on long term patient reported outcomes after trauma

“…However, by asking the patients about prior injury we likely improved our capture of the true trauma recurrence rate; the 49.3% rate of PTI in this study is at the upper end of the previously reported literature. 10,13,14,24,25,32 Last, our follow-up is limited to only 6 months in this study and longer follow-up times could show different results.…”

“…Trauma surgeons have long recognized the risk of recurrent injury as another component of this chronic disease process, and many studies have shown that a substantial proportion of trauma patients will experience another significant injury 10–14 . Yet, little research has considered the outcomes for patients with recurrent traumatic injury, and the few existing studies focus on acute outcomes such as mortality.…”

“…Yet, little research has considered the outcomes for patients with recurrent traumatic injury, and the few existing studies focus on acute outcomes such as mortality. The conflicting results of these studies have shown either improved or worsened immediate outcomes for patients with recurrent injury depending on the setting and methodology of the study 14–16 . To date, no research has evaluated the effect of repeated traumatic injury on long-term patient-reported outcomes.…”

“…9 Trauma surgeons have long recognized the risk of recurrent injury as another component of this chronic disease process, and many studies have shown that a substantial proportion of trauma patients will experience another significant injury. [10][11][12][13][14] Yet, little research has considered the outcomes for patients with recurrent traumatic injury, and the few existing studies focus on acute outcomes such as mortality. The conflicting results of these studies have shown either improved or worsened immediate outcomes for patients with recurrent injury depending on the setting and methodology of the study.…”

“…The conflicting results of these studies have shown either improved or worsened immediate outcomes for patients with recurrent injury depending on the setting and methodology of the study. [14][15][16] To date, no research has evaluated the effect of repeated traumatic injury on long-term patient-reported outcomes.…”