Citation

Aboutanos MB, Jordan A, Cohen R, Foster RL, Goodman K, Halfond RW, Poindexter R, Charles R, Smith SC, Wolfe LG, Hogue B, Ivatury RR. J. Trauma 2011; 71(1): 228-237.

Affiliation

Division of Trauma, Critical Care, and Emergency Surgery (M.B.A., A.J., R.P., R.C., S.C.S., R.R.I.), Department of Surgery, Virginia Commonwealth University Medical Center, Richmond, Virginia; Departments of Psychiatry (R.C.), Emergency Medicine (R.L.F.), Surgery (L.G.W.), Social Work (B.H.), Virginia Commonwealth University Medical Center, Richmond, Virginia; Department of Mental Health (K.G.), Johns Hopkins Bloomberg School of Public Health; and Department of Psychiatry (R.W.H.), University of South California Children's Hospital, Los Angeles, California.

Copyright

(Copyright © 2011, Lippincott Williams and Wilkins)

DOI

10.1097/TA.0b013e31821e0c86

PMID

21818029

Abstract

BACKGROUND:: Currently there are few data that brief violence intervention (BVI) and community case management services (CCMS) are effective for trauma patients admitted for interpersonal violence in terms of recidivism, service utilization, or alcohol abuse. The objective of this study is to assess outcomes for a cohort of young trauma patients in a prospective, randomized trial comparing BVI with BVI + CCMS. METHODS:: Intentionally injured patients, aged 10 years to 24 years, admitted to a Level I trauma center were randomized to receive a brief in-hospital psychoeducational violence intervention alone (Group I) or in combination with a 6 months wraparound CCMS (Group II) that included vocational, employment, educational, housing, mental health, and recreational assistance. Recidivism, alcohol use, and hospital and community service utilization were assessed at 6 weeks (6W) and 6 months (6M). RESULTS:: Seventy-five of 376 eligible injured patients were randomized into Group I and II. The two groups had similar demographics, injuries, and clinical outcomes. After discharge, percent clinic visits maintained was 57% in both the groups. Group II showed better hospital service utilization, CMS, and risk factor reduction at 6W and 6M. One patient in each group sustained a reinjury at 6M. CONCLUSIONS:: In-hospital BVI with community wraparound case management interventions can improve hospital and community service utilization both short- and long-term for high-risk injured patients. Longer follow-up is needed to show sustained reduction.

Language: en