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Pediatric and Young Adult Trauma Recidivism
Alison Lehane1, Elizabeth Wood1, Sarah Pranikoff1
1Department of Surgery, Atrium Health Wake Forest Baptist Medical Center, Winston-Salem, NC, USA.
Insights
Pediatric trauma recidivism, defined as repeat visits to a trauma center, disproportionately affects males, African Americans, and those experiencing penetrating injuries. Targeted interventions are crucial for prevention in this vulnerable population.
Area of Science:
- Pediatric Trauma Surgery
- Injury Prevention
- Public Health
Background:
- Unintentional injury is a leading cause of death in children.
- Understanding adult trauma recidivism characteristics can inform pediatric prevention strategies.
- This study evaluates pediatric trauma recidivism rates, demographics, and features.
Purpose of the Study:
- To determine the rates and demographic characteristics of pediatric and young adult trauma recidivism.
- To identify specific features associated with repeat trauma center visits in this age group.
- To inform the development of targeted trauma prevention interventions.
Main Methods:
- Retrospective review of patients aged 0-28 at a level-1 pediatric trauma center (January 2008 - April 2023).
- Comparison of patients with one or more prior trauma center visits (recidivists) versus those with single admissions.
- Statistical analysis using Chi-square tests to compare demographic and injury characteristics.
Main Results:
- Pediatric/young adult trauma recidivists constituted 4.4% of the total trauma population (n=14,613).
- Recidivists showed higher rates of males (82% vs 69%), African American race (36% vs 24%), penetrating trauma (33% vs 17%), and uninsured status (17% vs 12%).
- Recidivist patients predominantly originated from a specific urban zip code within Forsyth County, indicative of low socioeconomic status.
Conclusions:
- Pediatric/young adult trauma recidivism is linked to specific demographic and injury factors: male gender, African American race, penetrating trauma, and lack of insurance.
- Recidivists are often from areas with low socioeconomic status.
- Targeted interventions are essential for preventing recurrent trauma in this high-risk pediatric population.
Introduction:
Unintentional injury is the leading cause of death among children. Much can be gleaned from the adult literature in understanding the characteristics that lead to recidivism in efforts to establish interventions for prevention. Our study aims to evaluate the rates, demographics, and features of pediatric trauma recidivism.
Methods:
This was a retrospective single-institution review at a level-1 pediatric trauma center of children and young adults (ages 0-28) with traumatic injuries from January 2008 to April 2023. Patients with 1 or more prior visits to our institution's trauma center (recidivists) were identified and compared with those with single admissions. Chi-square tests were used to statistically analyze the two groups.
Results:
Pediatric/young adult trauma recidivists were 4.4% of the total trauma population captured (n = 14,613). Of the total trauma group, 55% were under 18 years old. Recidivists had higher percentages of patients who were male (82% vs 69%, P < .01), African American (36% vs 24%, P < .01), involved in penetrating trauma (33% vs 17%, P < .01), self-pay/uninsured (17% vs 12%, P < .01), and have abuse reported (5% vs 4%, P = .04). The primary county for recidivism patients was Forsyth with most patients from a specific zip code in an urban area of the county. The average time between visits for recidivists was 1,066 days.
Conclusions:
Pediatric/young adult trauma recidivism is associated with specific characteristics including male, African American race, penetrating trauma, and uninsured status. Recidivists are primarily presenting from a zip code with low socioeconomic status. It is critical to develop targeted interventions to help this population in trauma prevention.
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