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Survival and Risk Factors in Interpersonal Injuries: A Secondary Ecosocial Study.

Juan Sanjuan1, Alberto Federico García2, María Isabel Gutiérrez-Martínez3

  • 1Department of Surgery, Intensive Care, Serena del Mar Hospital, Cartagena, Colombia.

The Journal of Surgical Research
|January 9, 2026
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Summary

Interpersonal injuries significantly impact survival, with physiological severity and socioeconomic factors playing crucial roles. Addressing systemic inequities in trauma care is vital for improving outcomes in injured patients.

Keywords:
Ecosocial modelHealth care accessInjury severityInterpersonal injuriesKrieger modelPublic healthRisk factorsSurvival analysisTraumaTrauma centers

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Area of Science:

  • Public Health
  • Trauma Surgery
  • Social Epidemiology

Background:

  • Interpersonal injuries represent a significant public health challenge, particularly impacting young men.
  • This study investigates survival and risk factors associated with interpersonal injuries, utilizing an ecosocial framework.

Purpose of the Study:

  • To evaluate survival rates and identify risk factors in patients with interpersonal injuries.
  • To integrate biological and structural determinants of injury outcomes using Krieger's ecosocial model.

Main Methods:

  • Secondary analysis of an observational cohort of trauma patients from four referral centers in Cali, Colombia.
  • Classification of interpersonal injuries by mechanism, with analysis of macro-level (sociodemographic, insurance, institutional) and micro-level (physiological, anatomical) factors using Cox regression.

Main Results:

  • Of 856 trauma patients, 539 (61.5%) had interpersonal injuries, with a crude mortality of 12.8%.
  • Undetectable systolic blood pressure and a Glasgow Coma Scale score of 3 were strongly associated with mortality.
  • Severe traumatic brain and abdominal injuries increased mortality risk, while thoracic trauma showed a protective effect. Treatment at high-complexity hospitals and having no/subsidized insurance were linked to lower mortality.

Conclusions:

  • Trauma survival is influenced by a combination of physiological severity and structural determinants.
  • Strengthening trauma systems and reducing health inequities are crucial for improving patient outcomes.
  • The ecosocial framework provides a valuable perspective for trauma epidemiology and policy development.