Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #107312

Sara J. Russell, MSN, MPH, RN, Epidemic Intelligence Service Officer, CDC/Oklahoma State Department of Health, 1000 NE 10th St, Communicable Disease Division, Oklahoma City, OK 73117, 405-271-4060, bwf9@cdc.gov, Sue Mallonee, RN, MPH, Oklahoma State Deparment of Health, 1000 NE 10th Street, Oklahoma City, OK 73117, and Pam J. Archer, MPH, Injury Prevention Service, Oklahoma State Department of Health, 1000 NE 10th St, Oklahoma City, OK 73117.

In the United States, 1.4 million persons sustain a traumatic brain injury (TBI) each year at a cost of $56 billion dollars. Because death certificate data are used to estimate state and national incidence of TBI-related deaths, it is important to understand how accurate these estimates are and to identify any groups that are missed. TBI-related death was defined by narrative diagnoses associated with CDC-designated ICD-10 codes. Using probabilistic linking software, we matched death certificates with the ICD-10 codes to TBI-related death records from the Oklahoma injury surveillance system that utilizes medical examiner reports and hospital chart review. All concordant records were assumed to be cases, validated by review of a random sample. All discordant records were examined manually to determine case status. Logistic regression was used to determine the adjusted odds ratios (AOR) of being missed versus captured by death certificate-based surveillance. The model included sex, age, race, and cause of death. Overall, sensitivity of death certificate-based surveillance was 78%. Of the missed cases, the majority (62%) were due to the use of the non-specific term 'multiple trauma' as the cause of death. Death certificate surveillance was more likely to miss TBI-related deaths among persons aged ≥ 65 years (AOR=1.5; 95%C I=1.04¨C2.4); from traffic crashes (AOR=8.8; 95%CI=5.1¨C15.2); and from falls (AOR=7.1; 95%CI=3.6¨C13.7) than other categories. Death certificate surveillance underestimated TBI-related death, especially among certain groups and might lead to national underreporting of deaths. More detailed completion of death certificates would result in better estimates of TBI-related death.

Learning Objectives: "At the conclusion of this session, the participant will be able to

"
• Identify limitations of death certificate-based surveillance for TBI-related death in Oklahoma
• Describe the groups most likely to be missed by death certificate-based surveillance for TBI-related death
• Develop a plan for evaluating death certificate-based surveillance in their own state.
• Identify methods to improve the accuracy of death certificate-based surveillance

Keywords: Data/Surveillance, Traumatic Brain Injury

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.