TRAUMA IS A RECURRENT DISEASE

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.