Trauma recidivism in a Canadian province: a 14-year registry review

被引:8
作者
Erdogan, Mete [1 ]
Kureshi, Nelofar [2 ]
Asbridge, Mark [3 ,4 ,5 ]
Green, Robert S. [1 ,6 ]
机构
[1] Trauma Nova Scotia, Dept Hlth & Wellness, Halifax, NS, Canada
[2] Dalhousie Univ, Dept Surg, Div Neurosurg, Halifax, NS, Canada
[3] Dalhousie Univ, Dept Community Hlth, Halifax, NS, Canada
[4] Dalhousie Univ, Dept Epidemiol, Halifax, NS, Canada
[5] Dalhousie Univ, Dept Emergency Med, Halifax, NS, Canada
[6] Dalhousie Univ, Dept Crit Care, Halifax, NS B3H 4R2, Canada
关键词
mortality; recidivism; trauma; INTERVENTIONS; OUTCOMES; ALCOHOL; RISK;
D O I
10.1017/cem.2018.496
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Objectives To determine the rate of recurrent major trauma (i.e., trauma recidivism) using a provincial population-based trauma registry. We compared outcomes between recidivists and non-recidivists, and assessed factors associated with recidivism and mortality. Methods Review of all adult (>17 years) major trauma patients in Nova Scotia (2001-2015) using data from the Nova Scotia Trauma Registry. Outcomes of interest were mortality, duration of hospital stay, and in-hospital complications. Multiple regression was used to assess factors associated with recidivism and mortality. Results Of 9,365 major trauma patients, 2% (150/9365) were recidivists. Mean age at initial injury was 52 +/- 21.5 years; 73% were male. The mortality rate for both recidivists and non-recidivists was 31%. However, after adjusting for potential confounders the likelihood of mortality was over 3 times greater for recidivists compared to non-recidivists (OR 3.67, 95% CI 2.06-6.54). Other factors associated with mortality included age, male gender, penetrating injury, Injury Severity Score, trauma team activation (TTA) and admission to the intensive care unit. The only variables associated with recidivism were age (OR 0.98, 95% CI 0.97-1.00) and TTA (OR 0.59, 95% CI 0.34-0.96). Conclusions This is the first provincial investigation of major trauma recidivism in Canada. While recidivism was infrequent (2%), the adjusted odds of mortality were over three times greater for recidivists. Further research is warranted to determine the effectiveness of strategies for reducing rates of major trauma recidivism such as screening and brief intervention in cases of violence or substance abuse.
引用
收藏
页码:473 / 476
页数:4
相关论文
共 15 条
[1]   Brief Violence Interventions With Community Case Management Services Are Effective for High-Risk Trauma Patients DISCUSSION [J].
Schermer, Carol R. ;
Aboutanos, Michel B. .
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 2011, 71 (01) :236-237
[2]   Exploring trauma recidivism in an elderly cohort [J].
Allan, Bassan J. ;
Davis, James S. ;
Pandya, Reeni K. ;
Jouria, Jassin ;
Habib, Fahim ;
Namias, Nicholas ;
Schulman, Carl I. .
JOURNAL OF SURGICAL RESEARCH, 2013, 184 (01) :582-585
[3]   Definition, Classification and Diagnosis of Diabetes Mellitus [J].
Nauck, Matthias ;
Petermann, Astrid ;
Mueller-Wieland, Dirk ;
Kerner, Wolfgang ;
Mueller, Ulrich A. ;
Landgraf, Ruediger ;
Freckmann, Guido ;
Heinemann, Lutz .
DIABETOLOGIE UND STOFFWECHSEL, 2017, 12 :S94-S100
[4]   Patterns and outcomes among penetrating trauma recidivists: It only gets worse [J].
Brooke, Benjamin S. ;
Efron, David T. ;
Chang, David C. ;
Haut, Elliott R. ;
Cornwell, Edward E., III .
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 2006, 61 (01) :16-19
[5]   Trauma recidivism in a large urban Canadian population [J].
Caufeild, J ;
Singhal, A ;
Moulton, R ;
Brenneman, F ;
Redelmeier, D ;
Baker, AJ .
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 2004, 57 (04) :872-876
[6]   Trauma recidivists: surprisingly better outcomes than initially injured trauma patients [J].
Dixon, Shanteria D. ;
Como, John J. ;
Banerjee, Aman ;
Claridge, Jeffrey A. .
AMERICAN JOURNAL OF SURGERY, 2014, 207 (03) :427-431
[7]   Alcohol interventions in a trauma center as a means of reducing the risk of injury recurrence [J].
Gentilello, LM ;
Rivara, FP ;
Donovan, DM ;
Jurkovich, GJ ;
Daranciang, E ;
Dunn, CW ;
Villaveces, A ;
Copass, M ;
Ries, RR .
ANNALS OF SURGERY, 1999, 230 (04) :473-480
[8]   Deadly Partners: Interdependence of Alcohol and Trauma in the Clinical Setting [J].
Hayman, Amanda V. ;
Crandall, Marie L. .
INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH, 2009, 6 (12) :3097-3104
[9]  
IBM Corp, 2015, IBM SPSS STAT WIND V
[10]   A population-based study of trauma recidivism [J].
Kaufmann, CR ;
Branas, CC ;
Brawley, ML .
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 1998, 45 (02) :325-331