Department of Surgery, University of California, San Francisco-East Bay, Alameda County Medical Center, Oakland, California 94602, USA.
J Surg Res. 2011 Jan;165(1):25-9. doi: 10.1016/j.jss.2010.05.060. Epub 2010 Jun 16.
Gender differences among trauma recidivist patients are not well-understood. We hypothesized that males are more likely to be repeatedly involved in the trauma system and have a shorter time to recurrence between repeat episodes of injury compared with females.
A retrospective analysis of trauma patients treated at an urban university-based trauma center was performed. Variables including gender, race, insurance status, age, mechanism of injury, outcomes, and injury secondary to domestic violence were compared. Differences were compared using χ(2) tests and log-rank (Mantel-Cox) Kaplan-Meier cumulative event curves.
We identified 689 trauma recidivist patients (4.0% of all trauma visits) over a 10-y period. Compared to single-visit patients, recidivist patients were more likely to be male (87% versus 73%), uninsured (78% versus 66%), and have injuries secondary to assaults (54% versus 37%) (P < 0.05). Time from the first to second trauma visit was shorter for females compared with males (23 ± 2.5 versus 30 ± 1.2 mo, P < 0.02). Additionally, female recidivists were more likely to be involved in blunt trauma than were male recidivists (69% versus 43%, P < 0.001). Furthermore, domestic violence was identified in a higher proportion of female recidivist patients than female single-visit patients (3.5% versus 1.6%, P < 0.0003).
Contrary to our hypothesis, female recidivist trauma patients have a much shorter time to recurrence for a second traumatic injury than do males. Female recidivists have a high likelihood of assault-associated injuries and domestic violence. Trauma centers should screen for domestic violence among trauma patients to aid in preventing further repeat episodes of injury.
创伤再入院患者的性别差异尚未得到充分了解。我们假设与女性相比，男性更有可能反复卷入创伤系统，且两次受伤之间的复发时间更短。
对一家城市大学附属医院的创伤患者进行回顾性分析。比较了性别、种族、保险状况、年龄、损伤机制、结局以及是否与家庭暴力有关的损伤等变量。采用卡方检验和对数秩（Mantel-Cox）检验进行单因素分析，Kaplan-Meier 累积事件曲线进行多因素分析。
在 10 年期间，我们共发现 689 例创伤再入院患者（所有创伤就诊患者的 4.0%）。与单次就诊患者相比，再入院患者更有可能为男性（87%比 73%）、无保险（78%比 66%）、损伤继发于攻击（54%比 37%）（P<0.05）。女性从首次创伤就诊到第二次创伤就诊的时间比男性更短（23±2.5 比 30±1.2 个月，P<0.02）。此外，女性再入院患者更有可能发生钝器伤，而不是男性再入院患者（69%比 43%，P<0.001）。此外，女性再入院患者中家庭暴力的比例高于女性单次就诊患者（3.5%比 1.6%，P<0.0003）。
与我们的假设相反，女性创伤再入院患者第二次创伤的复发时间比男性短得多。女性再入院患者更有可能因攻击相关损伤和家庭暴力而再次受伤。创伤中心应筛查创伤患者中的家庭暴力，以帮助预防进一步的重复损伤发作。
