Intentional and unintentional injury in the State of Nevada: 1989–1992

Introduction: Data from a large population-based trauma registry were used to assess risk factors and outcomes associated with injuries that were either caused unintentionally, were self-inflicted, or resulted from an assault. Design: A retrospective analysis was conducted of all cases of serious trauma (N = 19,505) occurring in the State of Nevada during the 4-year period from January 1, 1989, through December 31, 1992. The outcome measures of interest were Injury Severity Score, hospitalization, and mortality. Results: Of all patients with unintentional injuries, 9.9% died compared with 44.8% of those whose injuries were intentionally caused. Nearly half (49.0%) of all deaths occurred in persons who were intentionally injured. Of the intentional injuries, 70% were from assaults. Self-inflicted injuries accounted for 5.2% of all injuries but 28.2% of the deaths in the registry. Firearms were most often used in both assaults (38.8%) and self-inflicted injuries (87.4%). Logistic regressions showed that, compared with unintentional injuries, assaults were more likely to occur in urban counties, among males, African Americans, and young adults. Also, compared with unintentional injuries, self-inflicted injuries were more likely to occur in urban counties, among Caucasian, and the 65+ age group. Conclusion: Although the overwhelming number of injuries in the registry were unintentionally caused, deaths from intentionally caused injuries accounted for almost half of all deaths. The data from Nevadaʹs registry provided the ability to identify who is at risk for trauma-related injury and death. Prevention programs should be designed to target these populations. As prevention programs are implemented, trauma registries such as Nevadaʹs will provide a sound source of data for assessing long-term trends in injury patterns.