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Citation
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Neufeld MY, Plaitano E, Janeway MG, Munzert T, Scantling D, Allee L, Sanchez SE. J. Trauma Acute Care Surg. 2023; ePub(ePub): ePub. |
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Abstract
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BACKGROUND: Violence-related reinjury impacts both patients and health care systems. Mental illness (MI) is prevalent among violently injured individuals. The relationship between pre-existing MI and violent reinjury among women has not been fully characterized. Our objective was to determine if risk of hospital reencounter -violent re-injury and all-cause - was associated with pre-existing MI at time of index injury among female victims of violence.
METHODS: All females (15-100 + yrs) presenting to a level I trauma center with violent injury (2002-2019) surviving to discharge were included (N = 1056). Exposure was presence of pre-existing MI. The primary outcome was hospital reencounters for violent re-injury and all-cause within one year (through 2020). The secondary outcome was the development of a new MI within one year of index injury. Odds of reencounter and development of new MI for those with and without pre-existing MI were compared with multivariable logistic regression, stratified for interaction when appropriate.
RESULTS: There were 404 women (38%) with pre-existing MI at time of index injury. Approximately 11% of patients with pre-existing MI experienced violent reinjury compared to 5% of those without within 1 year (P < 0.001). Specifically, those with MI in the absence of concomitant substance use had more than three times the odds of violent reinjury [aOR 3.52(1.57,7.93), P = 0.002]. Of those with pre-existing MI, 64% had at least one reencounter for any reason compared to 46% of those without (P < 0.001). Odds of all-cause reencounter for those with pre-existing MI were nearly twice of those without [aOR 1.81(1.36,2.42), P < 0.0001].
CONCLUSIONS: Among female victims of violence, pre-existing MI is associated with a significantly increased risk of hospital reencounter and violent reinjury within the first year after index injury. Recognition of this vulnerable population and improved efforts at addressing MI in trauma patients is critical to ongoing prevention efforts to reduce violent reinjury. LEVEL OF EVIDENCE: Original research; Prognostic/Epidemiological, Level III.
Language: en |