Background. Many victims of trauma have a history of repetitive accide
ntal or violent injuries, which implies that trauma is not necessarily
a random event. Recurrent trauma is thought to be a problem of urban
areas, associated with criminal activities, but there are few data fro
m rural areas that include the victims of nonintentinal injuries. Meth
ods. The prior trauma experience of 200 consecutive patients admitted
for trauma was compared with that of 100 consecutive emergency nontrau
ma surgical admissions and 100 elective surgical admissions to a unive
rsity hospital and level I trauma center. Results. Trauma patients wer
e younger than emergency patients and elective surgery patients. They
were more likely to be male than either emergency or elective surgery
patients and, along with emergency nontrauma patients, were more likel
y to be from a racial minority than were elective admissions. Trauma p
atients were more likely to have had a previous hospitalization for an
injury than either emergency patients or elective surgery patients, a
nd a greater proportion of their prior trauma admissions had been with
in the past 5 years than in the other two groups. There was no differe
nce in the probability of a prior trauma admission between patients ad
mitted with an intentional injury or an accidental injury, but patient
s whose current admission was for an intentional injury were three tim
es more likely to have had a prior hospitalization as a result of an i
ntentional injury than were patients admitted because of an accidental
injury. Conclusions. Trauma is a disease with a high risk of recurren
ce. This may be related to chronic high-risk behaviors such as alcohol
or drug abuse, preexisting psychopathology, and cultural acceptance o
f violent resolution of personal conflicts, all of which adversely aff
ect patients' lives. The role of intensive preventive measures after a
n initial injury, and directed toward specific high-risk behavior, sho
uld be evaluated.