Association Between Social Vulnerability Index and Hospital Readmission Following Gunshot Injuries

Abstract

IntroductionNo association regarding classification of social vulnerability and outcomes of patients with gunshot injury have been described. Our goal was to assess whether the socioeconomic vulnerability index (SVI), is associated with an increased risk of hospital readmission following gunshot wounds. MethodsWe conducted an exploratory retrospective cohort study on Massachusetts patients with trauma following gunshot wounds from January 1, 2012 to December 31, 2020 using the institutional trauma registry. We estimated the association between high social vulnerability (defined by the Centers for Disease Control and Prevention as ≥90th percentile) and incidence of all-cause readmission at 30, 60, and 90 d (overall and stratified over sex, race, and age groups). Estimates from unadjusted log-binomial regression were reported using relative risks (RRs) and 95% confidence intervals. Time-to-event (readmission) was assessed using Kaplan-Meier plots. ResultsA total of 386 patients were included for analysis: 211 (55%) with SVI <0.90 and 175 (45%) with SVI ≥0.90. The mean (standard deviation) age was 29 (13) y, with majority being male (89%). There was no strong risk of readmission associated with SVI ≥0.90; the interval with the greatest risk was at 60 d (RR = 1.34; 95% confidence interval [0.73, 2.45]). Among stratified analyses, the strongest associations were observed when restricting to young adults (aged 18-35) with RRs of 2.49, 2.62, and 2.45 for 30, 60, and 90 d readmission, respectively. ConclusionsOverall, high SVI was not associated with all-cause readmission; however, subanalyses suggest an association among young adults. Future research should explore SVI as a tool for identifying patients with trauma at risk for readmission.