Criminal correlates of injury-related emergency department recidivism

To investigate criminal and high-risk lifestyle factors that predict emergency department (ED) recidivism, a longitudinal (8-year) cohort study of ED trauma patients was conducted. Study patients provided risk and lifestyle behavior information via semi-structured interview. ED revisit and re-injury rates for 1995-2003 were acquired through hospital record review. Lifetime criminal arrest data were obtained for each study subject via record linkage from PublicData.com, an internet-based service. The 8-year ED re-visit rate was 47% (75/161), but revisits were more often medical than injury-related (30% vs. 17%, respectively). Over half (58%) of all injured ED patients had a documented arrest history, and arrests were significantly more common in those who came back to the ED for repeat trauma vs. those who did not revisit the ED (70.4% vs. 55.9%, respectively; p < 0.05). In this sample, 21% (34/161) had been convicted of 97 property-related crimes, 26% (42/161) of 109 violence-related crimes, 23% (37/161) of 98 drug-related offenses, and 17.4% (28/161) of 89 other non-traffic-related crimes. ED recidivism for trauma care was associated with multiple substance abuse behaviors and drug-related arrests. Significant risk factors for ED recidivism seem to be high-risk substance-abuse-related behaviors and criminal activity, constituting important targets for effective ED-based intervention, referral, and follow-up.