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Pediatric trauma recidivism in an urban cohort
James S Davis1, Reeni K Pandya, Juan E Sola
1Department of Surgery, University of Miami Miller School of Medicine, Miami, FL 33101, USA.
Insights
Pediatric trauma recidivism is low but concerning. Males with penetrating injuries, particularly gunshot wounds, are at higher risk, suggesting targeted interventions are needed.
Area of Science:
- Trauma Surgery
- Pediatric Surgery
- Public Health
Background:
- Recidivism is a significant issue in adult trauma care, yet data on pediatric trauma recidivism remains limited.
- Understanding the demographics, injury mechanisms, and outcomes of pediatric trauma recidivists is crucial for developing targeted prevention strategies.
- This study addresses the knowledge gap regarding pediatric trauma recidivism, hypothesizing that specific subgroups can be identified for focused interventions.
Purpose of the Study:
- To determine the recidivism rate among pediatric trauma patients.
- To identify demographic, injury, and outcome characteristics of pediatric trauma recidivists.
- To inform the development of targeted prevention efforts for pediatric trauma recidivism.
Main Methods:
- A retrospective review of pediatric trauma patients (0-19 years) admitted to a level 1 trauma center from 1991 to 2010.
- Data collected included age, sex, Glasgow Coma Scale score, injury location and cause, disposition, length of stay, and mortality.
- Comparison of characteristics between nonrecidivist and recidivist patient cohorts.
Main Results:
- The overall pediatric trauma recidivism rate was 1.5% (0-19 years) and 0.9% (0-16 years).
- Recidivists were predominantly male and more likely to sustain penetrating injuries, with a lower incidence of motor vehicle collision-related trauma.
- A significant proportion of recidivists with gunshot wounds (GSWs) had a history of prior GSWs.
Conclusions:
- The pediatric trauma recidivism rate in this urban setting is relatively low.
- Penetrating trauma, especially GSWs, is a key characteristic of pediatric trauma recidivists.
- Targeted screening and counseling for high-risk pediatric trauma patients, particularly those with penetrating injuries, may effectively reduce recidivism.
Background:
Recidivism is a well-known problem in adult trauma patients. Trauma recidivists are a population that warrants further intervention to prevent future trauma. Among pediatric patients, the recidivism rate, demographics, mechanism, and mortality are unknown. We hypothesized that specific groups of pediatric trauma recidivists could be identified for targeted prevention efforts.
Methods:
All pediatric trauma patients admitted to a level 1 pediatric trauma center in an urban county hospital between 1991 and 2010 were reviewed. Age, sex, Glasgow Coma Scale, injury location, injury cause, disposition, length of stay, and mortality were collected and compared between nonrecidivist and recidivist cohorts.
Results:
The recidivism rate among patients aged 0-19 y was 1.5% compared with 0.9% in those aged 0-16 y. Recidivists were more likely males (P < 0.001) suffering from penetrating injuries. They were less frequently injured in motor vehicle collisions. Two of every three recidivist gunshot wound (GSW) victims were injured by a GSW on their prior admission.
Conclusions:
The pediatric recidivism rate in our population is small. Nevertheless, recidivists are more than twice as likely to be injured by penetrating trauma, especially GSWs. Targeted screening and counseling in this demographic may be helpful in reducing youth trauma recidivism.
