Study objective: To report intracity, regional trauma, geographic, and demographic factors affecting risk of major intentional versus nonintentional trauma.
Design: One-year retrospective analysis of trauma-registry and census-tract databases.
Setting: Urban trauma system with patient entry by emergency medical services personnel.
Participants: Major trauma cases grouped by presumed intent to injure.
Interventions: We examined age- and sex-adjusted trauma rates for seven geographic intracity regions (comprising of 144 census tracts) to identify associations with population density, median household income, and race data. Rates and risk factors for intentional versus nonintentional trauma were compared.
Results: Two hundred fifty-seven intentional and 575 nonintentional major trauma system cases were identified. Both intentional (relative risk [RR], 7.0; 95% CI, 5.1 to 9.7) and nonintentional (RR, 2.7; CI, 2.3 to 3.3) injury populations were predominately male. Intentional-trauma victims were disproportionately nonwhite (RR, 4.1; CI, 3.2 to 5.1). The 15- to 24-year-old (RR, 20.3; CI, 16.7 to 24.6) and 25- to 34-year-old (RR, 15.3; CI, 12.7 to 18.4) age groups were more likely to sustain intentional trauma than the 0- to 14-year-old age group. Regional differences in occurrence rates were most pronounced for intentional trauma; 52% of all intentional traumas occurred within a small area of 14 census tracts. Residents in low median income households were more commonly subject to intentional injury.
Conclusion: Different demographic features affect intentional and nonintentional major trauma in Portland, Oregon. These features can be used to guide emergency medical services planning and injury-prevention measures.