Risk Factors of Injured Patients with Frequent Emergency Department Visits: A Single Center Study in Jeju Island

ABSTRACT

PURPOSE: For patients who suffer frequent injury, there could be several causes contributing to repeated occurrence of injury. Occupation, alcohol, substance, age, socioeconomic status, etc could be related to recidivism. In order to perform an analysis of preventable causes, we investigated the characteristics of injured patients who visited the emergency department (ED) frequently, compared with patients who visited the ED only once. METHODS: A retrospective cohort study was conducted. Data for this study were obtained from the injury surveillance system of the ED at Jeju National University Hospital. Patients who visited the ED between March 2009 and March 2011 were enrolled, and were observed over a period of 18 months. The Once group (OG) was defined as patients who visited the ED once, and the frequent group (FG) as patients who visited the ED more than twice. The following factors were investigated demographic data, medical condition, drug misuse and abuse, intention of injury, alcohol use, mechanism of injury, place of occurrence, and activity when injured. Chi square test/t-test and logistic regression analysis were performed for analysis of risk factors of FG patients. RESULTS: A total of 12,520 injured patients included 11,895(95.01%) patients in the OG and 625(4.99%) patients in the FG. The total number of injuries in the FG was 1,352. The mean age of patients in the FG was younger than that of patients in the OG by approximately six years (27.96 vs 34.61). Patients in the FG suffered a greater number of falls, blunt trauma than those in the OG, and injuries occurred more frequently at home. Risk factors for frequent visits to the ED included a younger age, alcohol associated injury, intentional injury, hypertension, diabetes, liver disease, mental illness, dementia, Parkinson's disease, and epilepsy. CONCLUSION: In order to prevent another injury, patients with medical conditions associated with injury recidivism and young people, and alcohol users should undergo screening and should receive education in the ED. In part, on the basis of our results, emergency medical service associated organizations can plan multidirectional injury prevention programs.