Geographical Information System Evaluation and Trends of Nonaccidental Trauma at a Level I Trauma Center, Pilot Study

Although trauma may be considered a random act, geographical patterns of trauma potentially emerge. Our institution is unique in that it rests at an intersection of two of the highest areas of poverty and assault in New York City and has adequate data to analyze these patterns.

We review the incident reports logged by emergency medical services (EMS) technicians arriving with intentionally injured trauma patients from January 1 to December 31, 2013 at a single institution. After acquisition of this data, it was placed into a computer file using an individual identifying numbers for each incident along with latitude and longitude coordinates determined by global positioning software for each event. The data were separated into blunt and penetrating categories. Penetrating trauma was further separated into the type of instrument used: edged weapon or firearm. Kernel density estimate using the Crimestat program was then performed to determine the epicenters with the highest incidents of nonaccidental trauma.

Two hundred eighty-three patients were evaluated for assault-related trauma. Two hundred fifty-four patients were included in the mapping of the data with almost equal blunt and penetrating trauma. Seventy-four percent of trauma occurred from 6 PM to 6 AM, and 41% occurring between midnight and 6 AM. Of patients, 32.7% were found to be assaulted at their home address. Regression analysis demonstrated that each type of trauma had unique epicenters of likelihood for occurrence.

We can only speculate the reasons for many of these results at this time and further research into the sociological, psychological, and environmental factors is required. A high proportion of patients are assaulted at their home addresses. Further study is necessary to improve patient care with additional data provided by emergency medical services, police departments and surrounding hospitals.