ArticleAnnals of surgery2014
Association between intentional injury and long-term survival after trauma.
Article in Annals of surgery, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
What it found
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Who cites it
13 citing papers in PubMed, 39 citations in OpenAlex.
- Characteristics, mechanisms, and medicolegal perspectives of fatal cardiothoracic injuries in a tertiary care center.Forensic science, medicine, and pathology · 2026Article
- Article
- Characteristics of a three-pronged continuum of care model for hospital-based violence intervention.Trauma surgery & acute care open · 2025Article
- Impact of novel psychosocial programming on readmission and recidivism rates among patients with violence-related trauma.Archives of orthopaedic and trauma surgery · 2023Article
- Hospital-based violence prevention programmes in South Wales Emergency Departments: A process evaluation protocol.PloS one · 2023Article
- The actual, long-term cost of intentional injury care among a cohort of Maryland Medicaid recipients.The journal of trauma and acute care surgery · 2022Article
- Implementation of programming for survivors of violence-related trauma at a level 1 trauma center.Trauma surgery & acute care open · 2021Article
- Higher Risk of Mortality in Intentional Traumatic Injuries; A Multivariate Regression Analysis of a Trauma Registry.Bulletin of emergency and trauma · 2020Article
- Violent trauma recidivism: Does all violence escalate?European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2018Article
- One-year and three-year mortality prediction in adult major blunt trauma survivors: a National Retrospective Cohort Analysis.Scandinavian journal of trauma, resuscitation and emergency medicine · 2018Article
- Trauma Recidivism Predicts Long-term Mortality: Missed Opportunities for Prevention (Retrospective Cohort Study).Annals of surgery · 2017Article
- Outcomes of trauma admission for falls: influence of race and age on inhospital and post-discharge mortality.American journal of surgery · 2016Article
- Observational
Corrections and comments
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Authors and funding
10 authors at 3 institutions in 1 country.
Funding
Abstract
objectiveTo determine the risk-adjusted mortality of intentionally injured patients within 7 to 9 years postinjury, compared with unintentionally injured patients.
backgroundViolent injury contributes significantly to trauma mortality in the United States. Homicide is the second leading killer of American youth, aged 15 to 24 years. Long-term survival among intentionally injured patients has not been well studied. It is also unknown whether intentionally injured patients have worse long-term survival compared with unintentionally or accidentally injured patients with equivalent injuries.
methodsAdult trauma patients admitted for 24 hours or more and discharged alive from the Johns Hopkins Hospital from January 1, 1998, to December 31, 2000, were included. The primary outcome was mortality within 7 to 9 years postinjury. Long-term patient survival was determined using the National Death Index. The association between injury intentionality and mortality was investigated using a Cox proportional hazard regression model, adjusted for confounders such as injury severity and patient race, socioeconomic status, and comorbid conditions. Overall differences in survival between those with intentional versus unintentional injury were also determined by comparing adjusted Kaplan-Meier survival curves.
resultsA total of 2062 patients met inclusion criteria. Of these, 56.4% were intentionally injured and 43.6% were unintentionally injured. Compared with unintentionally injured patients, intentionally injured patients were younger and more often male and from a zip code with low median household income. Approximately 15% of all patients had died within 7 to 9 years of follow-up. Older age and presence of comorbidities were associated with this outcome; however, intentional injury was not found to be significantly associated with long-term mortality rates. There was also no significant difference in survival curves between groups; intentionally injured patients were much more likely to die of a subsequent injury, whereas those with unintentional injury commonly died of noninjury causes.
conclusionsThere was no significant difference in mortality between intentionally injured and unintentionally injured patients within 7 to 9 years postinjury. These results confirm the long-term effectiveness of lifesaving trauma care for those with intentional injury. However, given that patients with intentional injuries were more likely to suffer a subsequent violent death, interventions focused on breaking the cycle of violence are needed.
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