ASSAULTS FROM PENETRATING TRAUMA IN THE STATE OF ILLINOIS

This study was undertaken to evaluate the incidence, epidemiology, and temporal relationships of assaults in the State of Illinois from pene trating trauma presenting to Level I and Level II trauma centers, and to project the impact of these variables on hospital staffing. A retro spective analysis was performed on 4 months of data (7/1/92 to 10/31/9 2) provided by the Illinois Department of Public Health describing con secutive assaults with firearms or knives presenting to all Level I an d Level II trauma facilities in the State of Illinois. Data were analy zed for epidemiological parameters including age, gender, and race. Ot her variables analyzed included trauma score, Glasgow Coma Scale (GCS) score, ethanol levels, urine toxicology results, and mortality. The d ata were also analyzed for temporal patterns of hospital presentations with respect to the time of day and day of the week. A total of 1,288 cases of penetrating wounds were analyzed. Of these, 881 (68.4%) resu lted from firearms and 407 (31.6%) resulted from stab wounds. Ages of all penetrating trauma victims ranged from less than 1 year to 84 year s of age. The mean age for firearm victims was 25.0 +/- 10.8 (SD) year s and 30.5 +/- 11.4 years for stabbing victims. Ninety percent of pene trating trauma victims were male and 10% were female. Seventy two perc ent of the victims were African American, 13% Hispanic, 13% Caucasian, and 2% other. Alcohol levels were available for 727 of the 1,288 (56. 4%) patients. Of these 727, 433 (59.6%) had measurable levels. The res ults of drug screens were available for 582 of the 1,288 (45.1%) victi ms. Of these 582, 208 (35.7%) were positive. Other than alcohol, cocai ne was the most frequently detected drug, accounting for 58.4% of the positive drug screens. Firearm victims had significantly lower trauma scores (10.5 v11.2) and GCS scores (13.2 v 14.3) than stab victims. Si gnificant circadian patterns of penetrating trauma were observed for b oth types of assaults. For assaults with firearms, the circadian rhyth m peaked at 23.1 +/- 0.36 hours. For assaults with knives, the circadi an rhythm peaked at 23.7 +/- 0.44 hours. Weekly patterns were not stat istically significant for each individual type of assault. However, wh en the data were pooled, a weekly pattern peaking on Thursday was obse rved. These patterns of presentation for assaults are a significant fi nding that may have implications for hospital staff scheduling of trau ma center physicians, nurses, technicians, security, social service, a nd other ancillary staff. (Am J Emerg Med 1998;16:553-556. Copyright ( C) 1998 by W.B. Saunders Company).