Violent injury is known to be a chronic, recurrent issue, with high rates of recidivism following initial injury. While the burden of violence is disproportionately felt among young Black men and in communities of color, examination of distinct risk factors and long-term outcomes for other racial and ethnic groups could lead to improved violence intervention strategies. In this study, we examined the risk of violent penetrating injury and long-term adverse outcomes by race and ethnicity. This retrospective study was performed using a cohort of 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 re-injury at one and 3 years after surviving a penetrating injury.Of the 4191 victims of violent injury, 12% were White, 18% were Hispanic, and the remaining 70% self-identified as Black. Within 3 years after initial injury, Black patients were at the greatest risk of all-cause violent re-injury (vs. Hispanic: HR = 1.46, 95%CI[1.15,1.85], p = 0.002; vs. White: HR = 1.89, 95%CI[1.40,2.57], p < 0.0001), particularly by gunshot wound (vs. Hispanic: HR = 2.04, 95%CI[1.29,3.22] p = 0.002; vs. White: HR = 2.34, 95%CI[1.19,4.60], p = 0.01). At 3-years following initial injury, White patients were at 2.03 times the risk for all-cause mortality, likely due to a 4.96 times greater risk of death by drug or alcohol overdose for White patients compared to Black patients (HR = 4.96, 95%CI[2.25,10.96], p < 0.0001). In conclusion, Black survivors of violent injury have a significantly higher risk of violent re-injury, particularly by gun violence, while White patients are at the highest risk for mortality due to the incidence of drug and alcohol overdose. Violence intervention programs with similar patient populations should explore options to collaborate with drug treatment programs to reach this vulnerable population.

中文翻译：

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暴力穿透伤和长期不良后果中的种族和民族差异。

众所周知，暴力伤害是一种慢性、反复发生的问题，初次受伤后的再犯率很高。虽然年轻的黑人男性和有色人种社区感受到的暴力负担不成比例，但对其他种族和族裔群体的不同风险因素和长期结果的检查可能会导致改进暴力干预策略。在这项研究中，我们按种族和族裔调查了暴力穿透伤的风险和长期不良后果。这项回顾性研究是使用 2006 年至 2016 年间因暴力穿透伤到波士顿医疗中心急诊科就诊的一组患者进行的。Cox 比例风险回归模型用于估计穿通伤后 1 年和 3 年全因死亡率和暴力再伤害风险的风险比 (HR) 和 95% 置信区间 (95%CI)。 4191 名暴力伤害受害者，12% 是白人，18% 是西班牙裔，其余 70% 自认为是黑人。初次受伤后 3 年内，黑人患者发生全因暴力再伤害的风险最大（与西班牙裔相比：HR = 1.46, 95%CI[1.15,1.85]，p = 0.002；与白人相比：HR = 1.89, 95%CI[1.40,2.57], p < 0.0001)，尤其是枪伤（对比西班牙裔：HR = 2.04, 95%CI[1.29,3.22] p = 0.002；对比白人：HR = 2.34, 95 %CI[1.19,4.60]，p = 0.01）。在初次受伤后 3 年，白人患者的全因死亡率风险是其 2.03 倍，可能是由于 4. 与黑人患者相比，白人患者因药物或酒精过量而死亡的风险高 96 倍（HR = 4.96，95% CI [2.25,10.96]，p < 0.0001）。总之，暴力伤害的黑人幸存者再次遭受暴力伤害的风险要高得多，尤其是枪支暴力，而白人患者因吸毒和酗酒过量而死亡的风险最高。具有类似患者群体的暴力干预项目应探索与药物治疗项目合作的选项，以帮助这一弱势群体。而由于药物和酒精过量的发生率，白人患者的死亡风险最高。具有类似患者群体的暴力干预项目应探索与药物治疗项目合作的选项，以帮助这一弱势群体。而由于药物和酒精过量的发生率，白人患者的死亡风险最高。具有类似患者群体的暴力干预项目应探索与药物治疗项目合作的选项，以帮助这一弱势群体。