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Addendum to Injury Morbidity and Mortality in Indiana

Addendum to Injury Morbidity and Mortality in Indiana. Injury Prevention Advisory Council Meeting June 21, 2012 Julie Wirthwein— Injury Prevention Epidemiologist. Division of Trauma and Injury Prevention. Overview. Background of State Injury Indicators Report

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Addendum to Injury Morbidity and Mortality in Indiana

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  1. Addendum to Injury Morbidity and Mortality in Indiana Injury Prevention Advisory Council Meeting June 21, 2012 Julie Wirthwein—Injury Prevention Epidemiologist Division of Trauma and Injury Prevention

  2. Overview • Background of State Injury Indicators Report • Injury mortality, hospitalization and emergency department (ED) data • Injury by intent • Fall-related injuries by type • Fire and hot object/substance injuries • Motor vehicle crash injuries by injured person type • Causes/mechanisms of traumatic brain injuries • Leading causes of injury death by age group

  3. Data Sources • Indiana Mortality Reports (http://www.in.gov/isdh/19096.htm) • Published by: Indiana State Department of Health (ISDH), Data Analysis Team (DAT) • Hospital Discharge Datasets (HDD), Inpatient and Emergency Department (ED) • Overseen by: ISDH, DAT; Indiana Hospital Association • Web-based Injury Statistics Query and Reporting System (WISQARS) (http://www.cdc.gov/injury/wisqars/index.html) • Centers for Disease Control and Prevention, 2006–2009

  4. State Injury Indicators • An injury indicator describes a health outcome of an injury, such as a hospitalization or death, or a factor known to be associated with an injury, such as a risk or protective factor among a specified population • Guidelines for injury surveillance developed by the State and Territorial Injury Prevention Directors Association (STIPDA) and the Council of State and Territorial Epidemiologists (CSTE) • Provides state injury programs with a standardized method for evaluating injury data that is comparable across states, the United States and territories

  5. State Injury Indicators—Injury Categories Causes of Injury • Unintentional Drowning (Drowning) • Unintentional Fall-related (Falls) • Unintentional Fire-related (Fire) • Firearm-related • Homicide/Assault • Poisoning • Motor Vehicle Traffic • Suicide/Suicide Attempt • Types of Injury • Traumatic Brain Injury (TBI) • Hip Fracture Admissions, aged 65 years and older

  6. State Injury Indicators • Overlaps exist among injury categories • Example: A firearm-related homicide could be included in the firearm-related, homicide and traumatic brain injury (TBI) death indicator totals • Mortality data include only Indiana residents whether or not the death occurred in-state • HDD characteristics • Restricted to non-federal, non-state, acute care facilities • No psychiatric, rehab, or long-term hospitals are included • Readmissions, transfers, and in-hospital deaths are included

  7. Injury Coding • Mortality Data: International Classification of Disease, Tenth Revision (ICD-10), (See Appendix A) • Hospital Discharge Data: International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM), (See Appendix B) • External causes of injury and poisoning codes (E-codes) • Capture how the injury or poisoning happened (cause), the intent (unintentional, intentional, undetermined), and the place where the event occurred • Are intended to provide data for injury research and evaluation of injury prevention strategies • Quality of data is dependent on the completeness and accuracy of E-codes • Indiana’s E-code percentage (Inpatient HDD) in 2009: 62.44% • Injury Hospitalization and Emergency Department Subsets were produced by searching principal diagnosis field for appropriate codes

  8. Overview of Mortality Data—Indiana, 2007–2009 • Death rate for all injuries combined was 60.0 deaths per 100,000 from 2007 to 2009, claiming 11,640 lives • Males were 2.4 times more likely than females to be fatally injured (86.2 versus 35.5 per 100,000) • Injury death rates were highest among those aged 85 years and older (286.1 per 100,000) Source: ISDH, Epidemiology Resource Center, DAT

  9. Overview of Mortality Data—Indiana, 2007–2009 • Leading causes of injury deaths among both sexes combined were poisonings (15.0 per 100,000), suicides (12.5 per 100,000), and motor vehicle crashes (12.3 per 100,000) • Leading causes of injury deaths among males were suicides (20.8 per 100,000), firearm-related incidents (19.4 per 100,000), and poisonings (18.8 per 100,000) • Leading causes of injury deaths among females were poisonings (11.2 per 100,000), motor vehicle crashes (6.9 per 100,000), and suicides (4.8 per 100,000) Source: ISDH, Epidemiology Resource Center, DAT

  10. Overview of Inpatient Hospital Discharge Data—Indiana, 2007–2009 • Leading causes of injury-related hospitalizations among both sexes combined were falls (163.2 per 100,000), poisonings (68.8 per 100,000), and motor vehicle crashes (45.2 per 100,000) • Males were 1.1 times more likely than females to be hospitalized because of an injury (496.8 versus 468.7 per 100,000) Source: ISDH, Epidemiology Resource Center

  11. Overview of Inpatient Hospital Discharge Data—Indiana, 2007–2009 • Leading causes of injury-related hospitalizations among males were falls (134.7 per 100,000), poisonings (62.1 per 100,000), and motor vehicle crashes (57.5 per 100,000) • Leading causes of injury-related hospitalizations among females were falls (178.6 per 100,000), poisonings (75.4 per 100,000), and suicides (47.2 per 100,000) Source: ISDH, Epidemiology Resource Center

  12. Overview of ED Hospital Discharge Data—Indiana, 2007–2009 • Leading causes of injury-related ED visits among both sexes combined were falls (1,900.5 per 100,000), motor vehicle crashes (604.2 per 100,000), and assaults (248.8 per 100,000) • Males were 1.1 times more likely than females to visit an ED because of an injury (9,407.3 versus 8,204.4 per 100,000) Source: ISDH, Epidemiology Resource Center

  13. Overview of ED Hospital Discharge Data—Indiana, 2007–2009 • Leading causes of injury ED visits among males were falls (1,730.3 per 100,000), motor vehicle crashes (566.2 per 100,000), and assaults (302.8 per 100,000) • Leading causes of injury ED visits among females were falls (2,035.3 per 100,000), motor vehicle crashes (643.3 per 100,000), and assaults (193.4 per 100,000) Source: ISDH, Epidemiology Resource Center

  14. Overview of ED Hospital Discharge Data—Indiana, 2007–2009 • Leading causes of injury ED visits among males were falls (1,730.3 per 100,000), motor vehicle crashes (566.2 per 100,000), and assaults (302.8 per 100,000) • Leading causes of injury ED visits among females were falls (2,035.3 per 100,000), motor vehicle crashes (643.3 per 100,000), and assaults (193.4 per 100,000) Source: ISDH, Epidemiology Resource Center

  15. V01–Y36 Y85–Y87 Y89 Injury Fatality ICD-10 Codes Injury and poisoning

  16. Overview of Injury Death Rates—Indiana, 2007–2009 *Age-adjusted

  17. Age-Adjusted Injury Death Rates by Cause/Type—Indiana, 2007–2009 Source: ISDH, Epidemiology Resource Center, DAT

  18. Age-Adjusted Injury Death Rates by Sex and Cause/Type—Indiana, 2007–2009 Source: ISDH, Epidemiology Resource Center, DAT

  19. Age-Adjusted Injury Death Rates by Sex—Indiana, 2007–2009 Source: ISDH, Epidemiology Resource Center, DAT

  20. Injury Death Rates by Sex and Age—Indiana, 2007–2009 Source: ISDH, Epidemiology Resource Center, DAT

  21. 800–909.2 909.4 909.9–994.9 995.5–995.59 995.80–995.85 Hospitalizations for All Injuries ICD-9-CM Codes Injury and poisoning

  22. Overview of Injury Hospitalization Rates—Indiana, 2007–2009

  23. Age-Adjusted Injury Hospitalization Rates by Cause/Type—Indiana, 2007–2009 Source: ISDH, Epidemiology Resource Center

  24. Age-Adjusted Injury Hospitalization Rates by Sex and Cause/Type—Indiana, 2007–2009 Source: ISDH, Epidemiology Resource Center

  25. Age-Adjusted Injury Hospitalization Rates by Sex—Indiana, 2007–2009 Source: ISDH, Epidemiology Resource Center

  26. Injury Hospitalization Rates by Age and Sex—Indiana, 2007–2009 Source: ISDH, Epidemiology Resource Center

  27. 800–909.2 909.4 909.9–994.9 995.5–995.59 995.80–995.85 ED Visits for All Injuries ICD-9-CM Codes Injury and poisoning

  28. Overview of Injury ED Visit Rates—Indiana, 2007–2009 *Age-adjusted

  29. Age-Adjusted Injury ED Visit Rates by Cause/Type—Indiana, 2007–2009 Source: ISDH, Epidemiology Resource Center

  30. Age-Adjusted Injury ED Visit Rates by Cause/Type and Sex—Indiana, 2007–2009 Source: ISDH, Epidemiology Resource Center

  31. Injury ED Visit Rates by Age and Sex—Indiana, 2007–2009 Source: ISDH, Epidemiology Resource Center

  32. Injury Deaths by Intent—Indiana, 2007–2009 N=11,643 Source: ISDH, Epidemiology Resource Center, DAT

  33. Intentional Injury Deaths by Type—Indiana, 2007–2009 N=3,447 Source: ISDH, Epidemiology Resource Center, DAT

  34. Injury Hospitalizations by Intent—Indiana, 2007–2009 N=68,041 Source: ISDH, Epidemiology Resource Center

  35. Intentional Injury Hospitalizations by Type—Indiana, 2007–2009 N=10,009 Source: ISDH, Epidemiology Resource Center

  36. Unintentional Fall-Related Deaths by Type—Indiana, 2007–2009 N=1,008 Source: ISDH, Epidemiology Resource Center, DAT

  37. Unintentional Fall-Related Hospitalizations by Type—Indiana, 2007–2009 N=32,912 Source: ISDH, Epidemiology Resource Center

  38. Unintentional Fall-Related ED Visits by Type—Indiana, 2007–2009 N=364,498 Source: ISDH, Epidemiology Resource Center

  39. Fire/Burn* Hospitalizations—Indiana, 2007–2009 N=1,370 Source: ISDH, Epidemiology Resource Center

  40. Fire/Burn* ED Visits—Indiana, 2007–2009 *Hot object/substance burns excluded from State Injury Indicators Report N=20,267 Source: ISDH, Epidemiology Resource Center

  41. Motor Vehicle Crash Deaths by Injured Person Type—Indiana, 2007–2009 N=2,364 Source: ISDH, Epidemiology Resource Center, DAT

  42. Motor Vehicle Crash Hospitalizations by Injured Person Type—Indiana, 2007–2009 N=8,639 Source: ISDH, Epidemiology Resource Center

  43. Motor Vehicle Crash ED Visits by Injured Person Type—Indiana, 2007–2009 N=113,553 Source: ISDH, Epidemiology Resource Center

  44. Causes/Mechanisms of TBI Deaths—Indiana, 2009 *Causes/mechanisms not mutually exclusive Source: ISDH, Epidemiology Resource Center, DAT

  45. Firearm-Related TBI Deaths by Selected Cause—Indiana, 2009 Source: ISDH, Epidemiology Resource Center, DAT

  46. Causes/Mechanisms of TBI Hospitalizations—Indiana, 2009 *Causes/mechanisms not mutually exclusive †Total less than 100% due to lack of e-codes and other unlisted causes/mechanisms (TBI e-code percentage: 76.1%) Source: ISDH, Epidemiology Resource Center

  47. Death Rates among Children Under Age One Year by Mechanism of Injury—Indiana and United States, 2000–2009* *Note change in years Source: WISQARS

  48. Death Rates among Children Ages 1–4 Years by Mechanism of Injury—Indiana and United States, 2000–2009 Source: WISQARS

  49. Death Rates among Children Ages 5–14 Years by Mechanism of Injury—Indiana and United States, 2000–2009 Source: WISQARS

  50. Death Rates among 15–24 Year Olds by Mechanism of Injury—Indiana and United States, 2007–2009 *Note change in years Source: WISQARS

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