N Clay Mann1, Stacey Knight, Lenora M Olson, Lawrence J Cook. 1. Intermountain Injury Control Research Center, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah 84108, USA. clay.mann@hsc.utah.edu
Abstract
BACKGROUND: This study examines the potential for misclassifying injury-related deaths reported in Vital Statistics and assesses the rate of postdischarge death among injured patients released from hospital, emergency department (ED), and emergency medical services (EMS) care. METHODS: Statewide death certificate, inpatient, ED, and EMS databases for 1996 through 1997 were probabilistically linked and information in each database compared. RESULTS: One thousand two hundred ninety-four injured inpatients or ED patients were matched with a death certificate record that listed an injury (56.3%) or illness (43.7%) as the primary cause of death. Injured decedents with an illness-coded cause of death were older (p < 0.001), with causes of death indicative of chronic medical conditions. Few deaths occurred within 30 days of inpatient discharge (6%); however, 38% and 9% of deaths in ED and EMS databases occurred after discharge from health care, respectively. Many deaths among EMS and ED patients occur in subsequent phases of care. CONCLUSION: Estimates of injury mortality substantially increase when using multiple independent databases.
BACKGROUND: This study examines the potential for misclassifying injury-related deaths reported in Vital Statistics and assesses the rate of postdischarge death among injured patients released from hospital, emergency department (ED), and emergency medical services (EMS) care. METHODS: Statewide death certificate, inpatient, ED, and EMS databases for 1996 through 1997 were probabilistically linked and information in each database compared. RESULTS: One thousand two hundred ninety-four injured inpatients or ED patients were matched with a death certificate record that listed an injury (56.3%) or illness (43.7%) as the primary cause of death. Injured decedents with an illness-coded cause of death were older (p < 0.001), with causes of death indicative of chronic medical conditions. Few deaths occurred within 30 days of inpatient discharge (6%); however, 38% and 9% of deaths in ED and EMS databases occurred after discharge from health care, respectively. Many deaths among EMS and ED patients occur in subsequent phases of care. CONCLUSION: Estimates of injury mortality substantially increase when using multiple independent databases.
Authors: Mary E Tinetti; Gail J McAvay; Terrence E Murphy; Cary P Gross; Haiqun Lin; Heather G Allore Journal: J Am Geriatr Soc Date: 2012-06-26 Impact factor: 5.562