Rural trauma recidivism: a different disease.

Hypothesis Unlike the well-characterized urban trauma recidivist (RC), factors associated with the rural RC remain undefined. In an attempt to devise preventative strategies, we theorized that the rural RC profile would be similar to that of urban counterparts. Design Retrospective review. Setting Rural, university-affiliated, level I trauma center. Patients All trauma patients admitted between January 1, 1994, and December 30, 2002. Interventions Identification and characterization of rural trauma RCs. Main Outcome Measures Trauma recidivism incidence, risk factors, and cost. Results Of 15 370 consecutive admissions, 528 (3.4%) were RCs. Demographic comparisons to a non-RC cohort demonstrated rural RCs to be significantly older (mean ± SD age, 55.9 ± 24.8 vs 39.7 ± 24.1 years), disproportionately white (65.2% [344/528] vs 56.5% [8386/14 842]), and more likely female (49.1% [259/528] vs 37.3% [5537/14 842]) ( P P P =.02). The total cost for all RC admissions exceeded $7 million. Conclusions The rural RC profile is strikingly different from urban counterparts. The common feature seems to be substance abuse. Correspondingly, prevention strategies for recidivism must be considerably different among rural and urban populations.