CODES and Traumatic CODES and Traumatic Brain Injury Research in Brain Injury Research in

Kentucky Kentucky

Kentucky Injury Prevention and Research Center

University of Kentucky School of Public Health

CODES Technical Assistance Meeting

Park City, Utah June 25-27, 2001

Creation of TBI Data SetCreation of TBI Data SetFile LinkagesFile Linkages

Trauma Registries

UB92

Death Certificates

TBI Data Set

Link and Remove

DuplicatesFilter TBI’s

Creation of TBI Data SetCreation of TBI Data SetResults for 1997-1999Results for 1997-1999

1997: 3,224 cases identified1997: 3,224 cases identified 1998: 2,457 cases identified1998: 2,457 cases identified 1999: linkage in progress1999: linkage in progress

Crash-TBI LinkageCrash-TBI Linkage

3,244 TBI’s

225,000 drivers

• 616 TBI cases linked to crash-involved drivers

Case-Control AnalysisCase-Control AnalysisOutcome: TBI/No TBIOutcome: TBI/No TBI

616 linked Crash-616 linked Crash-TBI recordsTBI records

Dropped non-injury Dropped non-injury crashes from the crashes from the unlinked Crash unlinked Crash recordsrecords

Randomly selected Randomly selected 1,232 records from 1,232 records from the remaining the remaining

CasesCases

ControlControlss

Independent Independent VariablesVariables AgeAge GenderGender Seat belt useSeat belt use Urban/rural locationUrban/rural location Type 1st harmful eventType 1st harmful event Vehicle typeVehicle type Driving under the influenceDriving under the influence Posted speed limitPosted speed limit Roadway conditionRoadway condition WeatherWeather Impact pointImpact point Highway typeHighway type

Selected ResultsSelected ResultsSeat Belt UseSeat Belt Use

Crash-involved drivers who were reported not Crash-involved drivers who were reported not wearing belts had 6.6 times greater risk of wearing belts had 6.6 times greater risk of TBITBI

Males ages 15-29Males ages 15-29 were 35% of all unbelted TBI’s were 35% of all unbelted TBI’s but only 21% of the population of Kentucky in 1997.but only 21% of the population of Kentucky in 1997.

Selected ResultsSelected ResultsDUIDUI

Crash-involved drivers who were reported Crash-involved drivers who were reported as suspected DUI had 2.3 times greater risk as suspected DUI had 2.3 times greater risk of TBIof TBI

Males ages 15-44Males ages 15-44 were 70% TBI’s suspected DUI were 70% TBI’s suspected DUI

Selected ResultsSelected ResultsUrban vs. Rural CrashesUrban vs. Rural Crashes

Crashes in rural areas had 1.5 times Crashes in rural areas had 1.5 times greater risk of TBI than crashes in urban greater risk of TBI than crashes in urban areasareas

Collisions with fixed objectsCollisions with fixed objects were 44% of rural were 44% of rural TBI crashes, and to 28% of urban TBI crashesTBI crashes, and to 28% of urban TBI crashes

Unsafe speed wasUnsafe speed was the primary contributing the primary contributing human factor in 24% of rural TBI crashes, 13.5% human factor in 24% of rural TBI crashes, 13.5% urban.urban.

Alcohol involvmentAlcohol involvment was the primary contributing was the primary contributing human factor in 14% of rural TBI crashes, 10% human factor in 14% of rural TBI crashes, 10% urban.urban.

Selected ResultsSelected ResultsElderly DriversElderly Drivers

Drivers 65 and over had 1.9 times greater Drivers 65 and over had 1.9 times greater risk of TBI than drivers under 65risk of TBI than drivers under 65

Driver inattention and failure to yield right of Driver inattention and failure to yield right of wayway were 52% of primary contributing human were 52% of primary contributing human factors for drivers 65 and over, and 21% for factors for drivers 65 and over, and 21% for drivers under 65.drivers under 65.

Unsafe speed and alcohol involvementUnsafe speed and alcohol involvement were were 37% of primary contributing human factors for 37% of primary contributing human factors for drivers under 65, and 4.5% for drivers 65 and drivers under 65, and 4.5% for drivers 65 and over.over.

Kentucky TBI Surveillance Kentucky TBI Surveillance System ProposalSystem Proposal

Kentucky crash dataKentucky crash data Emergency department data (UB92)Emergency department data (UB92) Mental health and retardationMental health and retardation RehabilitationRehabilitation MedicaidMedicaid

The proposed system would incorporate the following data sets, in addition to those already being linked (hospital inpatients, death certificates, and trauma registries)