Rural trauma recidivism: A different disease

Eric A. Toschlog, Scott G. Sagraves, Michael R. Bard, Paul J. Schenarts, Claudia C. Goettler, Mark A. Newell, Michael F. Rotondo

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Hypothesis: Unlike the well-characterized urban trauma recidivist (RC), factors associated with the rural RC remain undefined. In an attempt to devise preventative strategies, we theorized that the rural RC profile would be similar to that of urban counterparts. Design: Retrospective review. Setting: Rural, university-affiliated, level I trauma center. Patients: All trauma patients admitted between January 1, 1994, and December 30, 2002. Interventions: Identification and characterization of rural trauma RCs. Main Outcome Measures: Trauma recidivism incidence, risk factors, and cost. Results: Of 15 370 consecutive admissions, 528 (3.4%) were RCs. Demographic comparisons to a non-RC cohort demonstrated rural RCs to be significantly older (mean±SD age, 55.9±24.8 vs 39.7±24.1 years), disproportionately white (65.2% [344/528] vs 56.5% [8386/14 842]), and more likely female (49.1% [259/528] vs 37.3% [5537/14 842]) (P<.001 for all). Clinical comparisons revealed significant associations between recidivism and substance abuse. The percentage of positive blood ethanol screen results (58.7% [310/528] vs 39.9% [5923/14 842]) and the mean±SD blood ethanol content (132.1±139.9 mg/dL [28.7±30.4 mmol/L] vs 69.5±114.4 mg/dL [15.1±24.8 mmol/L]) were higher for RCs (P<.001 for both). In addition, cocaine use was significantly higher in the RC cohort (6.4% [34/528] vs 4.1% [607/14 842]; P=.02). The total cost for all RC admissions exceeded $7 million. Conclusions: The rural RC profile is strikingly different from urban counterparts. The common feature seems to be substance abuse. Correspondingly, prevention strategies for recidivism must be considerably different among rural and urban populations.

Original languageEnglish (US)
Pages (from-to)77-81
Number of pages5
JournalArchives of Surgery
Volume142
Issue number1
DOIs
StatePublished - Jan 22 2007

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Wounds and Injuries
Substance-Related Disorders
Ethanol
Costs and Cost Analysis
Urban Population
Trauma Centers
Rural Population
Cocaine
Demography
Outcome Assessment (Health Care)
Incidence

ASJC Scopus subject areas

  • Surgery

Cite this

Toschlog, E. A., Sagraves, S. G., Bard, M. R., Schenarts, P. J., Goettler, C. C., Newell, M. A., & Rotondo, M. F. (2007). Rural trauma recidivism: A different disease. Archives of Surgery, 142(1), 77-81. https://doi.org/10.1001/archsurg.142.1.77

Rural trauma recidivism : A different disease. / Toschlog, Eric A.; Sagraves, Scott G.; Bard, Michael R.; Schenarts, Paul J.; Goettler, Claudia C.; Newell, Mark A.; Rotondo, Michael F.

In: Archives of Surgery, Vol. 142, No. 1, 22.01.2007, p. 77-81.

Research output: Contribution to journalArticle

Toschlog, EA, Sagraves, SG, Bard, MR, Schenarts, PJ, Goettler, CC, Newell, MA & Rotondo, MF 2007, 'Rural trauma recidivism: A different disease', Archives of Surgery, vol. 142, no. 1, pp. 77-81. https://doi.org/10.1001/archsurg.142.1.77
Toschlog EA, Sagraves SG, Bard MR, Schenarts PJ, Goettler CC, Newell MA et al. Rural trauma recidivism: A different disease. Archives of Surgery. 2007 Jan 22;142(1):77-81. https://doi.org/10.1001/archsurg.142.1.77
Toschlog, Eric A. ; Sagraves, Scott G. ; Bard, Michael R. ; Schenarts, Paul J. ; Goettler, Claudia C. ; Newell, Mark A. ; Rotondo, Michael F. / Rural trauma recidivism : A different disease. In: Archives of Surgery. 2007 ; Vol. 142, No. 1. pp. 77-81.
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abstract = "Hypothesis: Unlike the well-characterized urban trauma recidivist (RC), factors associated with the rural RC remain undefined. In an attempt to devise preventative strategies, we theorized that the rural RC profile would be similar to that of urban counterparts. Design: Retrospective review. Setting: Rural, university-affiliated, level I trauma center. Patients: All trauma patients admitted between January 1, 1994, and December 30, 2002. Interventions: Identification and characterization of rural trauma RCs. Main Outcome Measures: Trauma recidivism incidence, risk factors, and cost. Results: Of 15 370 consecutive admissions, 528 (3.4{\%}) were RCs. Demographic comparisons to a non-RC cohort demonstrated rural RCs to be significantly older (mean±SD age, 55.9±24.8 vs 39.7±24.1 years), disproportionately white (65.2{\%} [344/528] vs 56.5{\%} [8386/14 842]), and more likely female (49.1{\%} [259/528] vs 37.3{\%} [5537/14 842]) (P<.001 for all). Clinical comparisons revealed significant associations between recidivism and substance abuse. The percentage of positive blood ethanol screen results (58.7{\%} [310/528] vs 39.9{\%} [5923/14 842]) and the mean±SD blood ethanol content (132.1±139.9 mg/dL [28.7±30.4 mmol/L] vs 69.5±114.4 mg/dL [15.1±24.8 mmol/L]) were higher for RCs (P<.001 for both). In addition, cocaine use was significantly higher in the RC cohort (6.4{\%} [34/528] vs 4.1{\%} [607/14 842]; P=.02). The total cost for all RC admissions exceeded $7 million. Conclusions: The rural RC profile is strikingly different from urban counterparts. The common feature seems to be substance abuse. Correspondingly, prevention strategies for recidivism must be considerably different among rural and urban populations.",
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N2 - Hypothesis: Unlike the well-characterized urban trauma recidivist (RC), factors associated with the rural RC remain undefined. In an attempt to devise preventative strategies, we theorized that the rural RC profile would be similar to that of urban counterparts. Design: Retrospective review. Setting: Rural, university-affiliated, level I trauma center. Patients: All trauma patients admitted between January 1, 1994, and December 30, 2002. Interventions: Identification and characterization of rural trauma RCs. Main Outcome Measures: Trauma recidivism incidence, risk factors, and cost. Results: Of 15 370 consecutive admissions, 528 (3.4%) were RCs. Demographic comparisons to a non-RC cohort demonstrated rural RCs to be significantly older (mean±SD age, 55.9±24.8 vs 39.7±24.1 years), disproportionately white (65.2% [344/528] vs 56.5% [8386/14 842]), and more likely female (49.1% [259/528] vs 37.3% [5537/14 842]) (P<.001 for all). Clinical comparisons revealed significant associations between recidivism and substance abuse. The percentage of positive blood ethanol screen results (58.7% [310/528] vs 39.9% [5923/14 842]) and the mean±SD blood ethanol content (132.1±139.9 mg/dL [28.7±30.4 mmol/L] vs 69.5±114.4 mg/dL [15.1±24.8 mmol/L]) were higher for RCs (P<.001 for both). In addition, cocaine use was significantly higher in the RC cohort (6.4% [34/528] vs 4.1% [607/14 842]; P=.02). The total cost for all RC admissions exceeded $7 million. Conclusions: The rural RC profile is strikingly different from urban counterparts. The common feature seems to be substance abuse. Correspondingly, prevention strategies for recidivism must be considerably different among rural and urban populations.

AB - Hypothesis: Unlike the well-characterized urban trauma recidivist (RC), factors associated with the rural RC remain undefined. In an attempt to devise preventative strategies, we theorized that the rural RC profile would be similar to that of urban counterparts. Design: Retrospective review. Setting: Rural, university-affiliated, level I trauma center. Patients: All trauma patients admitted between January 1, 1994, and December 30, 2002. Interventions: Identification and characterization of rural trauma RCs. Main Outcome Measures: Trauma recidivism incidence, risk factors, and cost. Results: Of 15 370 consecutive admissions, 528 (3.4%) were RCs. Demographic comparisons to a non-RC cohort demonstrated rural RCs to be significantly older (mean±SD age, 55.9±24.8 vs 39.7±24.1 years), disproportionately white (65.2% [344/528] vs 56.5% [8386/14 842]), and more likely female (49.1% [259/528] vs 37.3% [5537/14 842]) (P<.001 for all). Clinical comparisons revealed significant associations between recidivism and substance abuse. The percentage of positive blood ethanol screen results (58.7% [310/528] vs 39.9% [5923/14 842]) and the mean±SD blood ethanol content (132.1±139.9 mg/dL [28.7±30.4 mmol/L] vs 69.5±114.4 mg/dL [15.1±24.8 mmol/L]) were higher for RCs (P<.001 for both). In addition, cocaine use was significantly higher in the RC cohort (6.4% [34/528] vs 4.1% [607/14 842]; P=.02). The total cost for all RC admissions exceeded $7 million. Conclusions: The rural RC profile is strikingly different from urban counterparts. The common feature seems to be substance abuse. Correspondingly, prevention strategies for recidivism must be considerably different among rural and urban populations.

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