THE URBAN EPIDEMIOLOGY OF RECURRENT INJURY - BEYOND AGE, RACE, AND GENDER STEREOTYPES

Objectives: To profile all patients presenting to an urban ED with any injury, and to determine whether the rate of subsequent injury treate d in the ED varied by demographic and E-code (external mechanism of in jury) category, The hypothesis that young black males were disproporti onately at risk for re-injury was addressed. Methods: A cohort of cons ecutive patients presenting to an urban ED with any injury between Jan uary 1, 1991, and November 31, 1992, were followed prospectively for 1 year from their index visit dates. Any repeat ED visits due to injury were sought. The mean number of injury visits per year (the total num ber of ED injury visits for each patient divided by 1 year) was comput ed for the overall population and by race, age, gender, and E-code. Re sults: The sample consisted of 34,378 patients who made 41,813 visits to the ED for injury. Of these patients, 22% had a repeat injury in 1 year, with a cohort mean of 1.30 injury visits per year. This mean did not vary appreciably by race (black 1.33, white 1.27), age (1-17 yr, 1.21; 18-24 yr, 1.32; 25-64 yr, 1.34; >65 yr, 1.23), gender (males 1.3 3, females 1.27), or E-code category. Having a prior injury visit in t he preceding year was the best predictor of future injury (mean repeat visit rate = 2.08). Conclusions: When examining patients presenting w ith any injury to an urban ED, the mean numbers of injury visits are r emarkably similar across demographic and E-code categories. Although t here are factors that place patients at risk for recurrent injury, tho se factors are not demographic-all patients presenting to an ED with i njury should be considered at risk for re-injury.