Abstract
Background
Mental illness, substance abuse, and poverty are risk factors for violent injury,
and violent injury is a risk factor for early mortality that can be attenuated through
hospital-based violence intervention programs. Most of these programs focus on victims
under the age of 30 years. Little is known about risk factors or long-term mortality
among older victims of violent injury.
Objectives
To explore the prevalence of risk factors for violent injury among younger (age < 30 years)
and older (age 30 ≥ years) victims of violent injury, to determine the long-term mortality
rates in these age groups, and to explore the association between risk factors for
violent injury and long-term mortality.
Methods
Adults with violent injuries were enrolled between 2001 and 2004. Demographic and
injury data were recorded on enrollment. Ten-year mortality rates were measured. Descriptive
analysis and logistic regression were used to compare older and younger subjects.
Results
Among 541 subjects, 70% were over age 30. The overall 10-year mortality rate was 15%,
and was much higher than in the age-matched general population in both age groups.
Risk factors for violent injury including mental illness, substance abuse, and poverty
were prevalent, especially among older subjects, and were each independently associated
with increased risk of long-term mortality.
Conclusion
Mental illness, substance abuse, and poverty constitute a “lethal triad” that is associated
with an increased risk of long-term mortality among victims of violent injury, including
both younger adults and those over age 30 years. Both groups may benefit from targeted
risk-reduction efforts. Emergency department visits offer an invaluable opportunity
to engage these vulnerable patients.
Keywords
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Article info
Publication history
Published online: April 14, 2018
Accepted:
December 30,
2017
Received in revised form:
December 27,
2017
Received:
May 1,
2017
Footnotes
This work was presented at the Society for Academic Emergency Medicine Annual Meeting, New Orleans, LA, May 13, 2016.
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
