Violent and Fatal Youth Trauma: Is There a Missed Opportunity?
Introduction: Accidents and assaults (homicides) are the leading causes of death among the youth of the United States, accounting for 53.3% of deaths among children aged 1 to19 years. Victim recidivism,defined as repeated visits to the emergency department (ED) as a victim of violent trauma, is a si...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
eScholarship Publishing, University of California
2012-05-01
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| Series: | Western Journal of Emergency Medicine |
| Subjects: | |
| Online Access: | http://escholarship.org/uc/item/7sc64483 |
| _version_ | 1811289159819591680 |
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| author | Robert Madlinger, DO Mark Leber, MD Jennifer Matarlo, RN Cesar Ochoa, MD Christopher P. Shields, MD Nicholas D. Caputo, MD, MSc Muhammed Waseem, MD |
| author_facet | Robert Madlinger, DO Mark Leber, MD Jennifer Matarlo, RN Cesar Ochoa, MD Christopher P. Shields, MD Nicholas D. Caputo, MD, MSc Muhammed Waseem, MD |
| author_sort | Robert Madlinger, DO |
| collection | DOAJ |
| description | Introduction: Accidents and assaults (homicides) are the leading causes of death among the youth of the United States, accounting for 53.3% of deaths among children aged 1 to19 years. Victim recidivism,defined as repeated visits to the emergency department (ED) as a victim of violent trauma, is a significantly growing public health problem. As 5-year mortality rates for recidivism are as high as 20%,it is important to determine whether victims with a history of violent trauma are at increased risk for fatal outcome with their next trauma. We hypothesized that victims of violent trauma who have had 1 prior ED visit for violent trauma will have increased odds of fatal outcome.Methods: A retrospective chart review was conducted for patients presenting with penetrating trauma to the ED from January 1, 1999 to December 31, 2009. All patients between the ages of 15 to 25 years who presented to the ED for any penetrating trauma were included. Patients with prior presentations for penetrating trauma were compared to those patients who were first-time presenters to determine the odds ratio of fatal outcome.Results: Overall, 15,395 patients were treated for traumatic presentations. Of these, 1,044 met inclusion criteria. Demographically, 79.4% were Hispanic, 19.4% were African American, and 0.96% were Caucasian. The average age was 21 years, and 98% of the population was male. One hundred and forty-seven (14%) had prior presentations, and 897 (86%) did not. Forty of the 147 patients (27%)with prior presentations had a fatal outcome as compared to 29 patients of the 868 (3%) without prior presentations, with odds ratio of 10.8 (95% confidence interval, 6.4–18.1; Pearson v2, P , 0.001). The 5-year mortality rate for those patients with fatal outcomes was calculated at 16.5%.Conclusion: Patients who had prior ED visits for penetrating trauma were at greater risk for fatal outcomes compared to those with no prior visits. Therefore, trauma-related ED visits might offer an opportunity for education and intervention. This may help to prevent future fatalities. |
| first_indexed | 2024-04-13T03:49:57Z |
| format | Article |
| id | doaj.art-6538f6582a1440d4a1012b26e62776e7 |
| institution | Directory Open Access Journal |
| issn | 1936-900X 1936-9018 |
| language | English |
| last_indexed | 2024-04-13T03:49:57Z |
| publishDate | 2012-05-01 |
| publisher | eScholarship Publishing, University of California |
| record_format | Article |
| series | Western Journal of Emergency Medicine |
| spelling | doaj.art-6538f6582a1440d4a1012b26e62776e72022-12-22T03:03:51ZengeScholarship Publishing, University of CaliforniaWestern Journal of Emergency Medicine1936-900X1936-90182012-05-01132146150Violent and Fatal Youth Trauma: Is There a Missed Opportunity?Robert Madlinger, DOMark Leber, MDJennifer Matarlo, RNCesar Ochoa, MDChristopher P. Shields, MDNicholas D. Caputo, MD, MScMuhammed Waseem, MDIntroduction: Accidents and assaults (homicides) are the leading causes of death among the youth of the United States, accounting for 53.3% of deaths among children aged 1 to19 years. Victim recidivism,defined as repeated visits to the emergency department (ED) as a victim of violent trauma, is a significantly growing public health problem. As 5-year mortality rates for recidivism are as high as 20%,it is important to determine whether victims with a history of violent trauma are at increased risk for fatal outcome with their next trauma. We hypothesized that victims of violent trauma who have had 1 prior ED visit for violent trauma will have increased odds of fatal outcome.Methods: A retrospective chart review was conducted for patients presenting with penetrating trauma to the ED from January 1, 1999 to December 31, 2009. All patients between the ages of 15 to 25 years who presented to the ED for any penetrating trauma were included. Patients with prior presentations for penetrating trauma were compared to those patients who were first-time presenters to determine the odds ratio of fatal outcome.Results: Overall, 15,395 patients were treated for traumatic presentations. Of these, 1,044 met inclusion criteria. Demographically, 79.4% were Hispanic, 19.4% were African American, and 0.96% were Caucasian. The average age was 21 years, and 98% of the population was male. One hundred and forty-seven (14%) had prior presentations, and 897 (86%) did not. Forty of the 147 patients (27%)with prior presentations had a fatal outcome as compared to 29 patients of the 868 (3%) without prior presentations, with odds ratio of 10.8 (95% confidence interval, 6.4–18.1; Pearson v2, P , 0.001). The 5-year mortality rate for those patients with fatal outcomes was calculated at 16.5%.Conclusion: Patients who had prior ED visits for penetrating trauma were at greater risk for fatal outcomes compared to those with no prior visits. Therefore, trauma-related ED visits might offer an opportunity for education and intervention. This may help to prevent future fatalities.http://escholarship.org/uc/item/7sc64483RecidivismTraumaYouth |
| spellingShingle | Robert Madlinger, DO Mark Leber, MD Jennifer Matarlo, RN Cesar Ochoa, MD Christopher P. Shields, MD Nicholas D. Caputo, MD, MSc Muhammed Waseem, MD Violent and Fatal Youth Trauma: Is There a Missed Opportunity? Western Journal of Emergency Medicine Recidivism Trauma Youth |
| title | Violent and Fatal Youth Trauma: Is There a Missed Opportunity? |
| title_full | Violent and Fatal Youth Trauma: Is There a Missed Opportunity? |
| title_fullStr | Violent and Fatal Youth Trauma: Is There a Missed Opportunity? |
| title_full_unstemmed | Violent and Fatal Youth Trauma: Is There a Missed Opportunity? |
| title_short | Violent and Fatal Youth Trauma: Is There a Missed Opportunity? |
| title_sort | violent and fatal youth trauma is there a missed opportunity |
| topic | Recidivism Trauma Youth |
| url | http://escholarship.org/uc/item/7sc64483 |
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