174717 National estimates of injury incidence for patients treated in U.S. trauma centers compared to U.S. hospital emergency departments

Monday, October 27, 2008

Sandra M. Goble, MS , National Trauma Data Bank, American College of Surgeons, Chicago, IL
Joseph L. Annest, PhD , National Center for Injury Prevention and Control/OSP, Centers for Disease Control and Prevention, Atlanta, GA
David E. Clark, MD MPH , Center for Outcomes Research and Evaluation, Maine Medical Center, Portland, ME
Mark Faul, BS, MS, PhD , National Center for Injury Prevention and Control, Division of Injury Response, Centers for Disease Control and Prevention, Atlanta, GA
Avery Nathens, MD MPH PhD , Division Head General Surgery & Director of Trauma, St. Michael's Hospital, Toronto, ON, Canada
Melanie Neal, MS , National Trauma Data Bank, American College of Surgeons, Chicago, IL
Lei Li, PhD , Statistics and Epidemiology Unit, RTI International, Research Triangle Park, NC
Paul S. Levy, ScD , RTI Senior Fellow in Biostatistics and Epidemiology, RTI International, Research Triangle Park, NC
Purpose: To characterize national estimates of injuries treated in level I and level II trauma center hospitals compared to those treated in US hospital emergency departments (EDs) using data from the National Trauma Data Bank-National Sample Project (NTDB-NSP) and the National Electronic Injury Surveillance System-All Injury Program (NEISS-AIP).

Methods: National estimates from the NTDB-NSP and from the NEISS-AIP were analyzed by age and sex of the patient and for intent and unintentional causes of injury for 2006. For the NTDB-NSP, an injury case was defined as those in the trauma registry of sample hospitals with at least one valid ICD-9-CM injury diagnosis code and one external cause-of-injury code. For NEISS-AIP, injury cases were those treated in a NEISS sample hospital ED and then hospitalized or transferred for specialized care. Cases dead on arrival or who died in ED were excluded.

Results: Injured patients in the NTDB-NSP were more likely to be younger adults (1534 years of age) (34.6% vs. 26.2%, respectively), male (64.0% vs. 53.5%), injured motor vehicle traffic-occupant (31.9% vs. 11.9%), and assaults (11.3% vs. 6.3%), than those for the NEISS-AIP.

Conclusion: The study findings are consistent with expectations based on the patient population represented by these two national samples. NEISS-AIP is currently being used to track injuries by external causes of injury among all patients treated in US hospital EDs. When fully implemented, NTDB-NSP should be useful in tracking injury incidence by external cause of injury among severe trauma patients and for trauma care assessment.

Learning Objectives:
1. Describe the differences between the patient populations of NTDB-National Sample Project and the NEISS All Injury Program 2. Recognize the use and limitations of representative national samples of trauma center patients and emergency department patients 3. Describe differences in the leading external causes of injury for patients treated in U.S. trauma center compared to U.S. hospital emergency department.

Keywords: Injury, Surveillance

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Ph.D. National Center for Injury Prevention and Control, CDC
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.