Uncovering a missing demographic in trauma registries: epidemiology of trauma among American Indians and Alaska Natives in Washington State

Details

• Alternative Title:
  Inj Prev
• Personal Author:
  Hoopes, Megan J ; Dankovchik, Jenine ; Weiser, Thomas ; Cheng, Tabitha ; Bigback, Kristyn ; Knaster, Elizabeth S ; Sugerman, David E
• Description:
  Background
  
  The objectives of this study were to evaluate racial misclassification in a statewide trauma registry and to describe the epidemiology of trauma among the Washington American Indian and Alaska Native (AI/AN) population.
  
  Methods
  
  We performed probabilistic record linkage between the Washington Trauma Registry (2005–2009) and Northwest Tribal Registry, a dataset of known AI/AN. AI/AN patients were compared with caucasians on demographic, injury and clinical outcome factors. A multivariable model estimated odds of mortality.
  
  Results
  
  Record linkage increased ascertainment of AI/AN cases in the trauma registry 71%, from 1777 to 3039 cases. Compared with caucasians, AI/AN trauma patients were younger (mean age=36 vs 47 years, p<0.001) and more commonly male (66.5% vs 61.2%, p<0.001). AI/AN experienced more intentional injuries (suicide or homicide: 20.1% vs 6.7%, p<0.001), a higher proportion of severe traumatic brain injury (20.7% vs 16.8%, p=0.004) and were less likely than caucasians to use safety equipment such as seat belts/airbags (53.9% vs 76.7%, p<0.001). ISSs were similar (ISS >15: 21.4% vs 20.5%, p=0.63), and no difference was observed in mortality after adjustment for covariates (p=0.58).
  
  Conclusions
  
  Linkage to a state trauma registry improved data quality by correcting racial misclassification, allowing for a comprehensive description of injury patterns for the AI/AN population. AI/AN sustained more severe injuries with similar postinjury outcomes to caucasians. Future efforts should focus on primary prevention for this population, including increased use of seat belts and child safety seats and reduction of interpersonal violence and suicide.
  
  
• Subjects:
  Adult Algorithms Female Health Services Research Health Status Disparities Humans Indians, North American Inuit Male Medical Record Linkage Minority Groups Quality Improvement Registries Washington Wounds And Injuries

  More +
• Source:
  Inj Prev. 21(5):335-343
• Pubmed ID:
  25924945
• Pubmed Central ID:
  PMC5603226
• Document Type:
  Journal Article
• Funding:
  CC999999/Intramural CDC HHSUnited States/ ; R01 HS019972/HS/AHRQ HHSUnited States/ ; R01HS019972/HS/AHRQ HHSUnited States/
• Volume:
  21
• Issue:
  5
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:cc794dfeae7b328b572a4c9f41dda4cfe69b1faea978f60253efc2aba08e205f
• Download URL:
  https://stacks.cdc.gov/view/cdc/48232/cdc_48232_DS1.pdf
• File Type:
  [PDF - 531.99 KB ]