Patterns and outcomes among penetrating trauma recidivists: it only gets worse

J Trauma. 2006 Jul;61(1):16-9; discussion 20. doi: 10.1097/


Background: Trauma recidivism accounts for a significant proportion of visits to urban trauma centers. The current study was designed to characterize injury patterns among individual recidivists and analyze their impact on mortality.

Methods: Recidivists were identified within a trauma registry from an urban level-one trauma center from a period between 1997 and 2004. Demographic, injury type, and final disposition data were retrospectively reviewed. The primary outcomes measured were all-cause mortality and injury mechanism. The data were analyzed using the chi2 method, and logistic regression analysis.

Results: Among 15,973 total trauma visits, 2,511 (15.7%) were by recidivists, representing 1,528 unique patients. Of these recidivists, 794 (52%) had their first trauma admission during the period reviewed (84% male, 87% African-American, mean age 31 +/- 13 years). Blunt injuries only were identified in 43.8% patients, while 21.9% had penetrating injuries only, and 34.3% had a combination of injury patterns. Recidivists presenting with penetrating trauma as their initial injury were more likely to return with penetrating injuries on their second (58% vs. 25% [p < 0.001]) and third (68% vs. 24% [p < 0.001]) visits. The all-cause mortality of a penetrating injury was significantly higher than that of a blunt injury for both second (9.2% vs. 1.0% [p < 0.001]) and third (15.1% vs. 1.3% [p = 0.002]) visits. The likelihood of mortality increased over twofold for each subsequent penetrating trauma visit (odds ratio [OR]; 95% confidence interval [CI]; 2.20 [1.63-2.97], p < 0.001).

Conclusions: Individual recidivists with penetrating injuries are likely to return with the same injury pattern, and are at increased risk of death with each subsequent visit.

MeSH terms

  • Adult
  • Baltimore / epidemiology
  • Female
  • Humans
  • Incidence
  • Logistic Models
  • Male
  • Patient Readmission
  • Recurrence
  • Retrospective Studies
  • Risk
  • Risk-Taking
  • Violence
  • Wounds, Gunshot / epidemiology
  • Wounds, Gunshot / mortality
  • Wounds, Penetrating / epidemiology*
  • Wounds, Penetrating / mortality
  • Wounds, Stab / epidemiology
  • Wounds, Stab / mortality