Craig Warden1, Ritu Sahni, Craig Newgard. 1. Department of Emergency Medicine, Oregon Health & Science University, Portland, Oregon 97239, USA. warden@ohsu.edu
Abstract
OBJECTIVES: To determine clusters of trauma incidents with high injury severity and resource utilization and to test their association with census demographic information. METHODS: Using "trauma band" unique identifiers and probabilistic linkage for unmatched cases, we matched injury location information collected from a centralized regional trauma communications center to the state trauma system registry for patients directly transported to two level I trauma centers for the years 2001-2003 in a three-county area. The injury locations were aggregated at the census tract level using a geographic information system (GIS). Moran's I analysis was used to determine clusters of census tracts that had a high incidence of either total trauma injuries, Injury Severity Scores (ISSs) >15, or high resource use (in-hospital mortality, admission to the intensive care unit, or major nonorthopedic surgery). These clusters were then tested for association with census tract demographics using logistic regression. RESULTS: Eight thousand seven hundred fifty-one injured persons were directly transported from the tricounty area to a trauma center during the study period. The mean (+/- standard deviation) age was 37 +/- 21 years, 67.4% were male, 18.9% had ISSs >15, and 29.8% had a high-resource-use indicator. Moran's I analysis demonstrated a single large cluster of incidents for total injuries, ISS >15, and occurrence of a high-resource-use indictor that overlapped except for one small census tract. Logistic regression revealed that the high-risk cluster was associated with a higher prevalence of nonwhite population and vacant housing and a lower prevalence of foreign-born residents and family housing. CONCLUSIONS: GIS cluster analysis demonstrated high-risk census tracts for trauma incidents and associated population demographics. Geospatial analyses may assist injury prevention interventions and emergency medical services deployment strategies for trauma.
OBJECTIVES: To determine clusters of trauma incidents with high injury severity and resource utilization and to test their association with census demographic information. METHODS: Using "trauma band" unique identifiers and probabilistic linkage for unmatched cases, we matched injury location information collected from a centralized regional trauma communications center to the state trauma system registry for patients directly transported to two level I trauma centers for the years 2001-2003 in a three-county area. The injury locations were aggregated at the census tract level using a geographic information system (GIS). Moran's I analysis was used to determine clusters of census tracts that had a high incidence of either total trauma injuries, Injury Severity Scores (ISSs) >15, or high resource use (in-hospital mortality, admission to the intensive care unit, or major nonorthopedic surgery). These clusters were then tested for association with census tract demographics using logistic regression. RESULTS: Eight thousand seven hundred fifty-one injured persons were directly transported from the tricounty area to a trauma center during the study period. The mean (+/- standard deviation) age was 37 +/- 21 years, 67.4% were male, 18.9% had ISSs >15, and 29.8% had a high-resource-use indicator. Moran's I analysis demonstrated a single large cluster of incidents for total injuries, ISS >15, and occurrence of a high-resource-use indictor that overlapped except for one small census tract. Logistic regression revealed that the high-risk cluster was associated with a higher prevalence of nonwhite population and vacant housing and a lower prevalence of foreign-born residents and family housing. CONCLUSIONS: GIS cluster analysis demonstrated high-risk census tracts for trauma incidents and associated population demographics. Geospatial analyses may assist injury prevention interventions and emergency medical services deployment strategies for trauma.
Authors: Craig D Newgard; Robert H Schmicker; George Sopko; Dug Andrusiek; Walter Bialkowski; Joseph P Minei; Karen Brasel; Eileen Bulger; Ross J Fleischman; Jeffrey D Kerby; Blair L Bigham; Craig R Warden Journal: Am J Public Health Date: 2011-04 Impact factor: 9.308
Authors: Barbara Haas; Aristithes G Doumouras; David Gomez; Charles de Mestral; Donald M Boyes; Laurie Morrison; Avery B Nathens Journal: J Trauma Acute Care Surg Date: 2015-04 Impact factor: 3.313
Authors: Nicolas W Medrano; Cynthia Lizette Villarreal; Michelle A Price; Ellen MacKenzie; Kurt B Nolte; Monica J Phillips; Ronald M Stewart; Brian J Eastridge Journal: Trauma Surg Acute Care Open Date: 2019-04-11