Previous Trauma As a Risk Factor for Recurrent Trauma in Rural Northern Israel

Background: Recently, a few urban trauma centers reported on repetitiveness of injury in some population groups. The aim of this study is to evaluate the concept of "trauma recidivism" by measurement of the association of previous trauma events with acute trauma in a rural region of northern Israel with a specific sociocultural population mixture, low drug and alcohol abuse, and low levels of criminal activity.

Methods: A case-control study was conducted comparing 100 consecutive trauma cases with selected controls. The main predictor variable evaluated in this study was a history of previous significant traumatic events. Cases were defined as patients > 14 years of age hospitalized for acute trauma. Controls were selected from hospitalized patients with nontraumatic conditions. Logistic regression analysis was performed to adjust for potential sociodemographic confounding factors.

Results: The trauma group was significantly younger (p < 0.001) and predominantly male (p < 0.03). The incidence of "recurrent trauma" was highly significant in this group (p < 0.00001), and "injury-free intervals" were significantly shorter (p < 0.002). A history of previous significant traumatic events was a strong predictor for recurrent trauma (adjusted odds ratio, 10.36; 95% confidence interval, 3.10-34.58). Injury types and patterns differed in subgroups, although the demographic structure of the trauma recidivists group conformed to that of the general population.

Conclusions: In this limited population study from rural northern Israel, a previous history of significant trauma is associated with recurrent trauma. Sociodemographic and cultural factors do not appear to be strong predictors for recurrent trauma. Further research investigating trauma recidivism is needed to clarify these relationships.