Acute Care/Hospitalization

Trauma center patients are much more likely to have experienced previous traumas than the general population

The 2.5 million individuals admitted to U.S. hospitals after traumatic injury are far more likely to have suffered multiple traumas in their lives than the general population, according to a study supported in part by the Agency for Healthcare Research and Quality (HS11372). Traumatic life events including traumatic injury appear to be a chronic and recurring problem for these patients. Many of them have experienced a broad spectrum of prior traumas—such as childhood abuse and neglect and physical assault—which predate the current injury hospitalization, according to researchers from the University of Washington School of Medicine.

The researchers used a trauma history screen, developed for the National Comorbidity Survey (NCS), to assess prior trauma in a representative sample of injured acute care patients hospitalized at two level I trauma centers. The researchers compared the trauma histories of 66 intentionally injured (injuries such as physical assaults) and 185 unintentionally injured (injuries due to motor vehicle crashes or those sustained on the job) trauma patients with 5,873 NCS participants from the general population.

Only 11 percent of NCS general population respondents reported four or more lifetime traumas, but 61 percent of intentionally injured patients and 40 percent of unintentionally injured patients reported four or more lifetime traumas prior to the event that brought them to the trauma center. After adjusting for other factors, trauma patients were more likely to report all types of trauma except combat. Compared with the general population NCS sample, people in the intentionally injured group were more likely to be male, unmarried, unemployed, minority, uninsured, have a high school education, and use drugs and alcohol. People in the unintentionally injured group were more likely to be male, older, uninsured, and of lower income.

Details are in "Is it an accident? Recurrent traumatic life events in level I trauma center patients compared to the general population," by Sarah M. Ramstad, B.A., Joan Russo, Ph.D., and Douglas F. Zatzick, M.D., in the December 2004 Journal of Traumatic Stress 17(6), pp. 529-534.

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