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Urban trauma: a chronic recurrent disease.
D W Sims1, B A Bivins, F N Obeid
1Division of Trauma and Critical Care Surgery, Henry Ford Hospital, Detroit, Michigan 48202.
The Journal of Trauma
|July 1, 1989
Summary
Urban trauma may be a chronic disease, not just an acute event. Survivors face high rates of unemployment, substance abuse, re-injury, and a significant 5-year mortality rate.
Area of Science:
- Public Health
- Trauma Surgery
- Sociology
Background:
- Urban trauma is often perceived as an isolated incident.
- Victim lifestyle, environment, and socioeconomic factors may contribute to trauma recurrence.
- Understanding the long-term trajectory of urban trauma is crucial for effective intervention.
Purpose of the Study:
- To investigate the hypothesis that urban trauma is a chronic, recurrent condition.
- To determine the 5-year recurrence and mortality rates among survivors of violent urban trauma.
- To identify associated risk factors for recurrent trauma and mortality.
Main Methods:
- A 5-year follow-up study was conducted on 501 consecutive survivors of violent trauma.
- Data were collected from medical records, death certificates, Medical Examiner's records, and police files.
- Analysis included medical follow-up, trauma recurrence, employment status, substance abuse, criminal activity, and mortality.
Main Results:
- Of 263 patients with medical follow-up, 115 (44%) experienced recurrent trauma.
- A significant proportion of patients were unemployed (76%) and abused alcohol or drugs (62%).
- Over the follow-up period, 142 patients were involved in crimes, and 52 died, resulting in a 20% 5-year mortality rate.
Conclusions:
- Urban trauma exhibits characteristics of a chronic disease with a high recurrence rate.
- Socioeconomic factors like unemployment and substance abuse are strongly associated with recurrent trauma.
- The findings underscore the need for comprehensive, long-term management strategies for urban trauma survivors.