Utility of social vulnerability index in trauma: A systematic review

Traumatic injuries remain a leading cause of mortality across age groups. Despite advancements in medical care, addressing the broader determinants of health is essential. Social determinants of health (SDOH), including socioeconomic factors, play a crucial role in patient outcomes. The Social Vulnerability Index (SVI), developed by the CDC, integrates various indicators, providing a comprehensive framework for assessing community vulnerability. The objective of this study is to evaluate the connection between SVI and trauma patient outcomes. A systematic literature search was conducted using PubMed, EMBASE and Web of Science. Inclusion criteria consisted of studies that were peer reviewed, obtainable in English, used SVI as a measurement and involved blunt or penetrating trauma. Of the initial 623 papers 12 studies met inclusion criteria. In adult studies, high SVI correlated with increased trauma mortality, especially in specific domains like Household Composition and Disability. For gunshot injuries, residents of high SVI communities had a higher likelihood of recurrent injuries. Readmission rates showed mixed results, with potential associations in younger patients. Long-term outcomes, such as functional limitations and PTSD, were more prevalent in higher SVI quartiles. Pediatric studies indicated associations between SVI and outcomes like firearm injuries, intentional injuries, and rehabilitation admission rates. In summary, these studies collectively demonstrate that there is a predictive value that SVI carries as it relates to trauma outcomes, underscoring that targeted interventions and policies to address social vulnerabilities can be done using this index. Further research is imperative to delve into the intricate interactions between SVI and specific trauma outcomes, considering demographic variations and exploring the potential implications for public health interventions.