Abuse-related trauma forward medical care in a randomly sampled nationwide population

Cheng Maw Ho, Chih Hsin Lee, Jann Yuan Wang, Po Huang Lee, Hong Shiee Lai, Rey Heng Hu, Jin Shing Chen

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Abuse-related trauma remains a global health issue. However, there is paucity in nationwide reports. We aim to estimate the incidence of abuse-related trauma forward medical care and identify its characteristics and clinical course in Taiwan. Patients with trauma between 2005 and 2007 that occurred 3 months before or after a diagnosis of abuse were identified from a randomly sampled nationwide longitudinal health insurance database of 1 million beneficiaries. The patients' demographic data, injury pattern, and medical resource utilization were measured, stratified by age and sex, and compared using chi-square test. Risk factors of next trauma event were identified using Cox regression analysis. Ninety-three patients (65 females) were identified (mean age, 20.6 ± 16.3 years), including 61.3% under 18 years of age. For the first trauma event, 68 patients (73.1%) visited the emergency room, 63 (67.7%) received intervention, and 14 (15.1%) needed hospital care. Seven (7.5%), all less than 11 years old, had intracranial hemorrhage and required intensive care. Thirty-three (35.5%) left with complications or sequelae, or required rehabilitation, but all survived. Of the 34 victims of sexual abuse, 32 were aged less than 18 years. Men received more mood stabilizers or antipsychotics (50.0% vs 10.7%, P=0.030) and reeducative psychotherapy (25.0% vs 0, P=0.044). Risk factors for a next trauma event were injury involving the extremities (hazard ratio [HR]: 5.27 [2.45-11.33]) and use of antibiotics (HR: 4.21 [1.45-12.24]) on the first trauma event. Abuserelated trauma has heterogeneous presentations among subgroups. Clinicians should be alert in providing timely diagnosis and individualized intervention.

Original languageEnglish
Article numbere5214
JournalMedicine (United States)
Volume95
Issue number43
DOIs
Publication statusPublished - 2016

Fingerprint

Wounds and Injuries
Population
Intracranial Hemorrhages
Sex Offenses
Chi-Square Distribution
Critical Care
Health Insurance
Taiwan
Psychotherapy
Antipsychotic Agents
Hospital Emergency Service
Rehabilitation
Extremities
Regression Analysis
Demography
Databases
Anti-Bacterial Agents
Incidence

Keywords

  • Abuse
  • NHIRD
  • Trauma

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Abuse-related trauma forward medical care in a randomly sampled nationwide population. / Ho, Cheng Maw; Lee, Chih Hsin; Wang, Jann Yuan; Lee, Po Huang; Lai, Hong Shiee; Hu, Rey Heng; Chen, Jin Shing.

In: Medicine (United States), Vol. 95, No. 43, e5214, 2016.

Research output: Contribution to journalArticle

Ho, Cheng Maw ; Lee, Chih Hsin ; Wang, Jann Yuan ; Lee, Po Huang ; Lai, Hong Shiee ; Hu, Rey Heng ; Chen, Jin Shing. / Abuse-related trauma forward medical care in a randomly sampled nationwide population. In: Medicine (United States). 2016 ; Vol. 95, No. 43.
@article{2c4ef5f7da944a3db14a1e0cc9e99f35,
title = "Abuse-related trauma forward medical care in a randomly sampled nationwide population",
abstract = "Abuse-related trauma remains a global health issue. However, there is paucity in nationwide reports. We aim to estimate the incidence of abuse-related trauma forward medical care and identify its characteristics and clinical course in Taiwan. Patients with trauma between 2005 and 2007 that occurred 3 months before or after a diagnosis of abuse were identified from a randomly sampled nationwide longitudinal health insurance database of 1 million beneficiaries. The patients' demographic data, injury pattern, and medical resource utilization were measured, stratified by age and sex, and compared using chi-square test. Risk factors of next trauma event were identified using Cox regression analysis. Ninety-three patients (65 females) were identified (mean age, 20.6 ± 16.3 years), including 61.3{\%} under 18 years of age. For the first trauma event, 68 patients (73.1{\%}) visited the emergency room, 63 (67.7{\%}) received intervention, and 14 (15.1{\%}) needed hospital care. Seven (7.5{\%}), all less than 11 years old, had intracranial hemorrhage and required intensive care. Thirty-three (35.5{\%}) left with complications or sequelae, or required rehabilitation, but all survived. Of the 34 victims of sexual abuse, 32 were aged less than 18 years. Men received more mood stabilizers or antipsychotics (50.0{\%} vs 10.7{\%}, P=0.030) and reeducative psychotherapy (25.0{\%} vs 0, P=0.044). Risk factors for a next trauma event were injury involving the extremities (hazard ratio [HR]: 5.27 [2.45-11.33]) and use of antibiotics (HR: 4.21 [1.45-12.24]) on the first trauma event. Abuserelated trauma has heterogeneous presentations among subgroups. Clinicians should be alert in providing timely diagnosis and individualized intervention.",
keywords = "Abuse, NHIRD, Trauma",
author = "Ho, {Cheng Maw} and Lee, {Chih Hsin} and Wang, {Jann Yuan} and Lee, {Po Huang} and Lai, {Hong Shiee} and Hu, {Rey Heng} and Chen, {Jin Shing}",
year = "2016",
doi = "10.1097/MD.0000000000005214",
language = "English",
volume = "95",
journal = "Medicine; analytical reviews of general medicine, neurology, psychiatry, dermatology, and pediatries",
issn = "0025-7974",
publisher = "Lippincott Williams and Wilkins",
number = "43",

}

TY - JOUR

T1 - Abuse-related trauma forward medical care in a randomly sampled nationwide population

AU - Ho, Cheng Maw

AU - Lee, Chih Hsin

AU - Wang, Jann Yuan

AU - Lee, Po Huang

AU - Lai, Hong Shiee

AU - Hu, Rey Heng

AU - Chen, Jin Shing

PY - 2016

Y1 - 2016

N2 - Abuse-related trauma remains a global health issue. However, there is paucity in nationwide reports. We aim to estimate the incidence of abuse-related trauma forward medical care and identify its characteristics and clinical course in Taiwan. Patients with trauma between 2005 and 2007 that occurred 3 months before or after a diagnosis of abuse were identified from a randomly sampled nationwide longitudinal health insurance database of 1 million beneficiaries. The patients' demographic data, injury pattern, and medical resource utilization were measured, stratified by age and sex, and compared using chi-square test. Risk factors of next trauma event were identified using Cox regression analysis. Ninety-three patients (65 females) were identified (mean age, 20.6 ± 16.3 years), including 61.3% under 18 years of age. For the first trauma event, 68 patients (73.1%) visited the emergency room, 63 (67.7%) received intervention, and 14 (15.1%) needed hospital care. Seven (7.5%), all less than 11 years old, had intracranial hemorrhage and required intensive care. Thirty-three (35.5%) left with complications or sequelae, or required rehabilitation, but all survived. Of the 34 victims of sexual abuse, 32 were aged less than 18 years. Men received more mood stabilizers or antipsychotics (50.0% vs 10.7%, P=0.030) and reeducative psychotherapy (25.0% vs 0, P=0.044). Risk factors for a next trauma event were injury involving the extremities (hazard ratio [HR]: 5.27 [2.45-11.33]) and use of antibiotics (HR: 4.21 [1.45-12.24]) on the first trauma event. Abuserelated trauma has heterogeneous presentations among subgroups. Clinicians should be alert in providing timely diagnosis and individualized intervention.

AB - Abuse-related trauma remains a global health issue. However, there is paucity in nationwide reports. We aim to estimate the incidence of abuse-related trauma forward medical care and identify its characteristics and clinical course in Taiwan. Patients with trauma between 2005 and 2007 that occurred 3 months before or after a diagnosis of abuse were identified from a randomly sampled nationwide longitudinal health insurance database of 1 million beneficiaries. The patients' demographic data, injury pattern, and medical resource utilization were measured, stratified by age and sex, and compared using chi-square test. Risk factors of next trauma event were identified using Cox regression analysis. Ninety-three patients (65 females) were identified (mean age, 20.6 ± 16.3 years), including 61.3% under 18 years of age. For the first trauma event, 68 patients (73.1%) visited the emergency room, 63 (67.7%) received intervention, and 14 (15.1%) needed hospital care. Seven (7.5%), all less than 11 years old, had intracranial hemorrhage and required intensive care. Thirty-three (35.5%) left with complications or sequelae, or required rehabilitation, but all survived. Of the 34 victims of sexual abuse, 32 were aged less than 18 years. Men received more mood stabilizers or antipsychotics (50.0% vs 10.7%, P=0.030) and reeducative psychotherapy (25.0% vs 0, P=0.044). Risk factors for a next trauma event were injury involving the extremities (hazard ratio [HR]: 5.27 [2.45-11.33]) and use of antibiotics (HR: 4.21 [1.45-12.24]) on the first trauma event. Abuserelated trauma has heterogeneous presentations among subgroups. Clinicians should be alert in providing timely diagnosis and individualized intervention.

KW - Abuse

KW - NHIRD

KW - Trauma

UR - http://www.scopus.com/inward/record.url?scp=84995938482&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84995938482&partnerID=8YFLogxK

U2 - 10.1097/MD.0000000000005214

DO - 10.1097/MD.0000000000005214

M3 - Article

C2 - 27787382

AN - SCOPUS:84995938482

VL - 95

JO - Medicine; analytical reviews of general medicine, neurology, psychiatry, dermatology, and pediatries

JF - Medicine; analytical reviews of general medicine, neurology, psychiatry, dermatology, and pediatries

SN - 0025-7974

IS - 43

M1 - e5214

ER -