208758 Studying the lasting effects of trauma on the everyday function of young assault patients

Tuesday, November 10, 2009: 3:30 PM

Virginia Shalkey, BS , School of Medicine, University of Pennsylvania, Philadelphia, PA
Luke Basta, BS , Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA
Michael L. Nance, MD , Department of Surgery, Children's Hospital of Philadelphia, Philadelphia, PA
Charles C. Branas, PhD , Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA
Judd Hollander, MD , School of Medicine, Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA
C. William Schwab, MD, FACS , Division of Traumatology and Surgical Critical Care, Department of Surgery, University of Pennsylvania, Philadelphia, PA
Therese Richmond, PhD, CRNP, FAAN , School of Nursing, University of Pennsylvania, Philadelphia, PA
Douglas Wiebe, PhD , Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA
Background: Most assault patients presenting to trauma centers survive, but many have residual physical and emotional wounds following discharge that warrant extended care. We conducted a pilot study to assess the prevalence of such conditions among patients post discharge, and to assess whether follow-up phone calls provide a feasible method to recruit this patient population for research purposes.

Methods: 18-24 year-old patients who had been treated for assault-related gunshot wound (GSW) or non-GSW injuries at an urban Level 1 trauma center were called 1-12 months post discharge for a short telephone interview regarding their health. Eligible patients were those who had participated in another study by our investigative team at the time they were treated (n=62).

Results: In making calls to the 62 patients, we learned that 3 GSW patients had been killed since discharge and 3 were incarcerated and thus ineligible. 10 GSW and 11 non-GSW patients were successfully enrolled (42.0%), which required placing fully 509 calls (mean=9/patient). Compared to non-GSW patients, GSW patients reported significantly more (p<0.05) difficulty performing moderate activities (7 vs. 1) and climbing stairs (8 vs. 0), pain during normal activities (8 vs. 5), and higher mean PTSD symptom scores (3.2 vs. 1.5, p<0.05) with having nightmares being most the notable symptom (10 vs. 3, p<0.05).

Conclusion: The physical and emotional wounds of young GSW patients are frequent, may last long after discharge, and are more common among this patient population than among patients with non-gun assault. Recruiting patients for larger-scale studies will be challenging.

Learning Objectives:
Describe the lasting impact of assault-related trauma on patients. Explain the difficulty involved in trying to study this patient population.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Expertise in the field
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.