Violent injury is known to be a chronic, recurrent issue, with high rates of recidivism in the 5 years following initial injury. Much of the strategy behind violence intervention programs, who are tasked with reducing recidivism, is directed toward young men, while there has been little research into the unique risk factors or long-term outcomes for female victims of violence. The aim of this study was to examine the risk of violent injury and long-term adverse outcomes by gender. This retrospective study was performed using a cohort of 4337 patients presenting to the Boston Medical Center emergency department for a violent penetrating injury between 2006 and 2016. Cox proportional hazards regression models were used to estimate hazard ratios (HR) and 95% confidence intervals (95% CI) for the risk of all-cause mortality and violent reinjury at 1 and 3 years after surviving a penetrating injury. There were 88 deaths (2.1%) and 568 violent reinjuries (13.2%) within 3 years after surviving the initial penetrating injury. At initial injury presentation, women were more likely to have a preexisting mental health diagnosis and to have been injured as a result of domestic violence. While men had greater than six times the risk of 3-year mortality compared to women (HR = 6.36, 95% CI = 1.56–25.83), both genders were equally at risk for violent reinjury (HR = 1.23, 95% CI = 0.95–1.59). Men were more likely to have a stab wound (HR = 2.68, 95% CI = 1.41–5.10) or gunshot wound (HR = 7.96, 95% CI = 2.95–21.48) reinjury, while women were more likely to have an assault (HR = 1.52, 95% CI = 1.13–2.04) or domestic violence (HR = 2.96, 95% CI = 1.43–6.12) reinjury. Compared to men, the risk of violent reinjury was significantly increased for women with a history of substance use disorders (p-interaction = 0.009). These results suggest a unique trifecta of risks for women—substance use, mental illness, and domestic violence—and underscore the critical role of violence intervention programs in addressing these risks to mitigate violent injury recidivism.

中文翻译：

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暴力穿透性伤害和长期不良后果的性别差异

众所周知，暴力伤害是一个慢性、反复发作的问题，在初次受伤后的 5 年内复发率很高。旨在减少再犯的暴力干预计划背后的大部分战略都是针对年轻男性的，而对女性暴力受害者的独特风险因素或长期结果的研究很少。本研究的目的是检查按性别划分的暴力伤害风险和长期不良后果。这项回顾性研究使用了 4337 名在 2006 年至 2016 年期间因暴力穿透伤就诊于波士顿医疗中心急诊科的患者。Cox 比例风险回归模型用于估计穿透性损伤幸存后 1 年和 3 年全因死亡和暴力再损伤风险的风险比 (HR) 和 95% 置信区间 (95% CI)。在最初的穿透伤幸存后的 3 年内，有 88 人死亡 (2.1%) 和 568 人再次暴力受伤 (13.2%)。在最初的伤害表现中，女性更有可能有预先存在的心理健康诊断，并因家庭暴力而受伤。虽然男性 3 年死亡率的风险是女性的 6 倍以上（HR = 6.36，95% CI = 1.56–25.83），但两性再次遭受暴力伤害的风险相同（HR = 1.23，95% CI = 0.95 –1.59）。男性更可能有刺伤 (HR = 2.68, 95% CI = 1.41–5.10) 或枪伤 (HR = 7.96, 95% CI = 2.95–21.48) 再受伤，而女性更有可能再次受到攻击（HR = 1.52，95% CI = 1.13–2.04）或家庭暴力（HR = 2.96，95% CI = 1.43–6.12）。与男性相比，有物质使用障碍病史的女性再次遭受暴力伤害的风险显着增加。p交互作用 = 0.009）。这些结果表明女性面临着独特的三重风险——物质使用、精神疾病和家庭暴力——并强调了暴力干预计划在解决这些风险以减轻暴力伤害再犯方面的关键作用。