DECEMBER 4, 2013 TRAUMA REGISTRY MORTALITY STATISTICS. Liana Lujan
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1 DECEMBER 4, 213 TRAUMA REGISTRY MORTALITY STATISTICS Liana Lujan Trauma Program EMS Bureau Epidemiology and Response Division New Mexico Department of Health
2 2
3 TRAUMA REGISTRY DEATHS METHODS Definitive Trauma Registry Records (DTRR) This report utilizes primarily Definitive Trauma Registry Records (DTRR). A DTRR is a record generated when a patient meets the state trauma registry inclusion criteria and does not have exclusion criteria, is then discharged from a facility to a non-acute care setting, (i.e., home, rehab or jail) or is discharged as dead. Patients who were transferred to a higher level of care within New Mexico were captured at the receiving facility. No out of state facility records were utilized for the purpose of this report. Trauma deaths, defined as DTRR s with a discharge status of dead, were also used extensively in this report. The subset of deaths categorized as Dead on Arrival (DOA), defined as a patient who had a pre hospital systolic blood pressure of and was pronounced dead after arrival to the emergency department, was removed from the total number of deaths. Motor vehicle traffic injuries (MVT) included motor vehicle traffic injures, pedal cyclist injury, pedestrian injuries, and motorcycle injuries. RESULTS The trauma registry program reviewed injury deaths in New Mexico utilizing IBIS data (Figure 1), and Figure 2 looks at trauma registry deaths versus trauma registry deaths that do not include those identified as DOA. In 212 there were 1939 injury deaths, 21 Trauma Registry (1.4%) and 164 Trauma Registry Excluding DOA s (8.4%). From , there was little to no change in the injury death rate (Figure 1), whereas the number of trauma registry deaths increased by 3.% from to
4 Figure Injury Death Rate*, New Mexico Per 1K *Age adjusted to 2 U.S. Standard Population Source IBIS, NMDOH Table 1 Trauma Registry Records with an Outcome of Death, New Mexico Number of Injury, New Mexico Number DTRR with an outcome of Death Percent of Injury Captured by DTRR Number of DTRR Excluding DOA Number of DTTR Records % % % % % % % % 164 Figure 2 7.% 6.% 5.% 4.% 3.% 2.% 1.%.% 5.4% Percent of Trauma Registry Records with an Outcome of Death Definitive Trauma Registry Record % 6.% 4.2% 5.6% 3.8% 4.2% 4.3% 3.8% 3.4% 3.9% 3.4% 3.% 3.1% 3.2% 2.7% % Discharged Dead % Of deaths excluding DOA 4
5 Figure 3 and Table 2 show some differences between Legacy Trauma Centers and Developing Trauma Centers. Legacy trauma centers are trauma centers designated prior to 27. For the purpose of Figure 3 and Table 2, Developing Trauma Centers are facilities that began developing in 25 and were designated as a trauma center in 27. These include: Table 2 Carlsbad Medical Center Gerald Champion Regional Medical Center Roosevelt General Hospital Eastern New Mexico Medical Center Nor-Lea General Hospital Trauma Registry Records by Year; and Number of Trauma Registry ; Legacy Trauma Centers and Developing Trauma Centers, New Mexico LEGACY TRAUMA CENTERS DEVELOPING TRAUMA CENTERS Number Number of TOTAL NUMBER NUMBER OF DEATHS Figure 3 Percent of DTRRs Excluding DOA s Legacy Trauma Centers and Developing Trauma Centers N = Legacy TC ; 928, Developing Trauma Center ; 7 6.% 5.% 4.% 3.% 2.% 1.% 4.5% 1.% 5.3%.7% 4.8% 1.3% 4.1% 4.1% 2.8%.7%.7%.7% 3.6% 2.1% 3.2% 1.2%.% Legacy Trauma Centers Developing Trauma Centers Since 25, and Designated 27 5
6 Table 3 Trauma Registry Records by Year and ISS; Excluding DOA s TOTAL ARRIVAL YEAR ISS 1-8 ISS 9 ISS 1-15 ISS ISS >=25 Grand Grand DEATHS EXCLUDING DOA s ARRIVAL YEAR ISS 1-8 ISS 9 ISS 1-15 ISS ISS >=25 Grand Grand PERCENT OF DTRR WITH A DEATH EXCLUDING DOA ARRIVAL YEAR ISS 1-8 ISS 9 ISS 1-15 ISS ISS >=25 Grand 25.4% 1.6% 1.4% 5.8% 3.3% 3.6% 26.4% 1.6%.2% 4.5% 32.% 4.% 27.5% 2.7% 1.8% 3.8% 3.1% 3.7% 28.7% 3.1% 1.5% 4.8% 26.7% 3.1% 29.3% 2.9%.7% 4.1% 32.8% 3.% 21.4% 3.1% 2.% 2.8% 21.6% 2.3% 211.5% 3.2% 2.7% 6.1% 3.7% 2.9% 212.4% 2.4% 2.1% 6.% 33.7% 2.5% Grand
7 Figure 8 Figure 7 Figure 6 Figure 5 Figure 4 Figures 4-8.8%.6%.4%.2%.% 4.% 3.% 2.% 1.%.% 3.% 2.% 1.%.% 8.% 6.% 4.% 2.%.% 5.% 25.%.% Percent of DTTR with a Death by ISS Range ISS 1-8 ISS 9 ISS 1-15 ISS ISS >=25 7
8 Table 4 Trauma Registry Records by Cause of Injury and Year TOTAL CAUSE OF INJURY Grand Falls Fire/Burn GSW Motor Vehicle Traffic Other/Assault Stabbing Struck By/Against Unknown TOTAL DEATHS CAUSE OF INJURY Grand Falls Fire/Burn GSW Motor Vehicle Traffic Other/Assault Stabbing Struck By/Against Unknown TOTAL PERCENT OF DTRRs WITH A DEATH EXCLUDING DOA CAUSE OF INJURY Grand Falls 3.5% 3.6% 3.6% 3.8% 3.3% 3.2% 3.% 2.1% 3.1% Fire/Burn.%.% 3.3% 2.7% 1.7% 2.8% 1.8% 1.8% 2.2% GSW 6.5% 2.8% 1.6% 5.8% 13.2% 6.4% 12.4% 6.8% 8.7% Motor Vehicle Traffic 3.% 3.% 3.9% 3.2% 2.9% 1.8% 2.8% 3.4% 3.% Other/Assault 8.6%.% 2.8% 2.2% 4.5% 1.6% 3.8% 3.7% 3.3% Stabbing.%.9% 2.3% 1.8%.7%.3%.6%.8% 1.% Struck By/Against.%.7% 1.% 1.8% 1.5% 1.3% 1.9% 1.4% 1.4% Unknown 4.6% 6.3% 2.2% 3.% 5.%.%.% 5.3% 5.4% TOTAL 3.% 2.9% 3.7% 3.3% 3.2% 2.4% 3.% 2.5% 3.% 8
9 Figure 9 Figures % 3.% 2.% 1.%.% Percent of DTRR with a Death by Cause of Injury Falls Figure 1 Figure 11 Figure 12 4.% 3.% 2.% 1.%.% 15.% 1.% 5.%.% 5.% 4.% 3.% 2.% 1.%.% Fire/Burn Gun Shot MVT 9
10 Table 5 Fall Trauma Registry Records by Year and ISS TOTAL FALLS BY ISS YEAR ISS 1-8 ISS 9 ISS 1-15 ISS ISS >=25 Grand Grand FALL DEATHS BY ISS YEAR ISS 1-8 ISS 9 ISS 1-15 ISS ISS >=25 Grand Grand PERCENT OF FALL DTRR WITH A DEATH YEAR ISS 1-8 ISS 9 ISS 1-15 ISS ISS >=25 Grand 25.3% 2.9%.% 16.7% 61.5% 3.6% % 2.8%.% 8.5% 5.% 3.6% % 3.4% 2.1% 5.9% 39.2% 3.6% % 4.6% 3.4% 1.7% 34.6% 3.8% 29.5% 4.5% 3.2% 8.8% 37.9% 3.3% 21.9% 4.% 5.9% 4.2% 43.1% 3.2% 211.7% 3.2% 5.% 1.8% 36.4% 3.% 212.5% 2.5% 3.2% 6.2% 35.5% 2.1% Grand.8% 3.5% 3.5% 8.1% 39.7% 3.1% 1
11 Figures Percent of Fall DTRR with a Death by ISS ISS 1-8 Figure 13 2.% 1.%.% Figure 17 Figure 16 Figure 15 Figure 14 5.% 2.5%.% 1.% 5.%.% 2.% 15.% 1.% 5.%.% 1.% 5.%.% ISS 9 ISS 1-15 ISS ISS >=25 11
12 Table 6 MVT Trauma Registry Records by Year and ISS TOTAL MVT BY ISS YEAR ISS 1-8 ISS 9 ISS 1-15 ISS ISS >=25 Grand Grand MVT DEATHS BY ISS YEAR ISS 1-8 ISS 9 ISS 1-15 ISS ISS >=25 Grand Grand PERCENT OF MVT DTRR WITH A DEATH YEAR ISS 1-8 ISS 9 ISS 1-15 ISS ISS >=25 Grand 25.3% 2.2% 2.7% 3.4% 21.2% 3.% 26.% 1.5%.% 3.% 24.7% 3.% 27.%.4% 2.% 1.5% 27.3% 3.9% 28.2%.6% 1.4% 3.7% 23.% 3.2% 29.1%.5%.% 2.6% 25.3% 2.9% 21.3%.%.4% 2.3% 15.6% 1.8% 211.5% 1.7% 1.6% 4.2% 24.5% 2.7% 212.3% 2.5% 1.6% 6.% 31.7% 3.5% Grand.3% 1.1% 1.2% 3.4% 24.2% 3.% 12
13 Figures Percent of MVT DTRRs with a Death by ISS Figure 22 Figure 21 Figure 2 Figure 19 Figure 18.6%.4%.2%.% 3.% 2.% 1.%.% 3.% 2.% 1.%.% 8.% 6.% 4.% 2.%.% 4.% 3.% 2.% 1.%.% ISS 1-8 ISS 9 ISS 1-15 ISS ISS >=25 13
14 Table 7 TOTA GSW GSW DTRR by Year and ISS YEAR ISS 1-8 ISS 9 ISS 1-15 ISS ISS >=25 Grand Grand GSW DEATHS YEAR ISS 1-8 ISS 9 ISS 1-15 ISS ISS >=25 Grand Grand PERCENT OF GSW DTRRs WITH A DEATH BY ISS YEAR ISS 1-8 ISS 9 ISS 1-15 ISS ISS >=25 Grand 25.%.%.%.% 27.3% 6.5% 26.%.%.% 1.% 5.9% 2.8% 27.%.%.% 11.1% 37.2% 1.6% 28.%.%.%.% 31.4% 5.8% 29.%.%.% 12.% 52.4% 13.2% 21.% 7.3%.% 6.3% 27.6% 6.4% 211.% 2.5% 4.2% 16.% 6.% 12.4% 212.% 2.9% 7.7% 11.8% 36.% 6.8% Grand.% 5.1% 1.8% 9.% 36.9% 8.7% Note: No deaths from GSW with an ISS range of
15 Figures Percent of GSW DTRRs with a Death by ISS Figure % 2.% 15.% 1.% 5.%.% ISS 9 Figure 24 1.% 8.% 6.% 4.% 2.%.% ISS 1-15 Figure 25 2.% 15.% 1.% 5.%.% ISS Figure 26 8.% 6.% 4.% 2.%.% ISS >=25 15
16 16
17 Ages to 14 Years 17
18 Table 8 Trauma Registry Records Ages to 14 Years TOTAL Ages to 14 Years by Specific Cause and Year Cause of Injury Grand Falls Fire/Burn GSW Machinery MVC Other Assault Other Cause Other Suicide 1 1 Stabbing Struck By/Against Grand Ages to 14 Years by Specific Cause and Year Cause of Injury Grand Falls GSW MVC Other Assault Grand Percent of DTRRs with a Death, Ages to 14 Years Cause of Injury Grand - 1.6% 3.7%.%.%.%.%.%.% 2.6% Falls.9%.%.%.%.%.%.4%.%.1% GSW.% 33.3%.%.% 7.1%.%.%.% 3.3% MVC 1.5% 1.1%.6%.6% 1.% 1.4% 1.% 1.1% 1.% Other Assault.%.%.%.% 14.3%.% 5.6% 3.8% 3.5% Grand 1.2% 2.%.2%.2%.6%.4%.6%.5%.6% 18
19 Figures Number of Trauma Registry Records and by Ages to 14 Years Falls Figure GSW Figure 27 MVC Figure 28 19
20 Table 9 Trauma Registry Records Ages to 14 Years TOTAL Ages to 14 Years by Year and ISS YEAR ISS 1-8 ISS 9 ISS 1-15 ISS ISS >=25 Unknown Grand Grand Ages to 14 Years by Year and ISS YEAR ISS 1-8 ISS 9 ISS 1-15 ISS ISS >=25 Unknown Grand Grand Percent of DTRR with a Death Ages to 14 Years YEAR ISS 1-8 ISS 9 ISS 1-15 ISS ISS >=25 Unknown Grand 25.%.%.%.% 15.6%.%.9% 26.%.% 1.7%.% 21.6%.% 1.5% 27.%.%.%.% 2.4%.%.1% 28.%.%.%.% 2.6%.%.1% 29.%.%.% 4.1% 9.1%.%.4% 21.%.%.%.% 7.1%.%.3% 211.%.8%.%.% 13.6%.%.4% 212.%.7%.%.% 9.1%.%.3% Grand.%.2%.2%.7% 9.8%.%.5% 2
21 Ages 15 to 34 Years 21
22 Table 1 Trauma Registry Records Ages 15 to 34 Years TOTAL Ages 15 to 34 years by Specific Cause and Year Cause of Injury Grand Falls Fire/Burn GSW Machinery MVC Other Assault Other Cause Other Suicide Stabbing Struck By/Against Unknown Grand Ages 15 to 34 Years by Specific Cause and Year Cause of Injury Grand Falls Fire/Burn 1 1 GSW MVC Other Assault Other Cause Other Suicide Stabbing Struck By/Against Unknown Grand Percent of DTRR with a Death Ages 15 to 34 Years Cause of Injury Grand Falls 1.5%.%.6%.5%.5%.4% 1.2%.9%.7% Fire/Burn.%.%.%.%.% 2.1%.%.%.4% GSW 9.4%.% 9.3% 4.7% 16.2% 4.4% 1.3% 5.1% 7.8% MVC 1.1% 1.9% 2.8% 1.8% 2.8% 1.4% 2.1% 2.% 2.1% Other Assault.%.% 3.6%.%.%.%.% 3.2%.9% Other Cause.% 3.4% 2.2% 1.9%.%.% 2.4%.% 1.1% Other Suicide.%.%.%.% 1.% 14.3%.%.% 5.3% Stabbing.%.% 2.6% 1.2%.6%.5%.% 1.%.8% Struck By/Against.%.%.%.% 1.5%.%.6%.%.3% Unknown 3.1% 4.7%.%.%.%.%.%.% 3.8% Grand 2.1% 2.7% 2.6% 1.5% 2.8% 1.1% 2.% 1.6% 2.% 22
23 Figures Number of Trauma Registry Records Ages 15 to 34 Years Figure Falls Figure GSW Figure MVC
24 Table 11 Trauma Registry Records Ages 15 to 34 Years TOTAL Ages 15 to 34 years by Year and ISS YEAR ISS 1-8 ISS 9 ISS 1-15 ISS ISS >=25 Unknown Grand Grand Death Ages 15 to 34 by Year and ISS YEAR ISS 1-8 ISS 9 ISS 1-15 ISS ISS >=25 Unknown Grand Grand Percent of DTRR with a Death Ages 15 to 34 Years YEAR ISS 1-8 ISS 9 ISS 1-15 ISS ISS >=25 Unknown Grand 25.%.%.% 1.1% 13.1%.% 1.6% 26.%.%.%.9% 15.7%.% 2.2% 27.%.4%.% 1.9% 17.9%.% 2.1% 28.1%.%.%.6% 12.7%.% 1.2% 29.%.%.%.5% 22.1%.% 2.% 21.% 1.3%.%.9% 9.3%.%.8% 211.% 2.% 1.2% 3.4% 14.9%.% 1.5% 212.1%.8%.4% 3.4% 16.2%.% 1.3% Grand.%.6%.2% 1.6% 15.5%.% 1.5% 24
25 Ages 35 to 64 Years 25
26 Table 12 Trauma Registry Records Ages 35 to 64 Years TOTAL Ages 35 to 65 Years Cause of Injury Grand Falls Fire/Burn GSW Machinery MVC Other Assault Other Cause Other Suicide Stabbing Struck By/Against Unknown Grand Ages 35 to 64 Years Cause of Injury Grand Falls Fire/Burn GSW Machinery MVC Other Assault Other Cause Other Suicide Stabbing Struck By/Against Unknown Grand Percent of DTRRs with a Death Ages 35 to 64 Years Cause of Injury Grand Falls 1.% 1.5% 1.4% 1.8% 2.1% 2.5% 2.2% 2.1% 2.% Fire/Burn.%.% 4.3% 2.2% 5.4% 1.5%.% 3.3% 2.5% GSW.% 7.1% 12.2% 7.5% 5.6% 1.6% 13.8% 8.5% 9.4% Machinery.%.% 5.6%.%.% 2.5%.%.% 1.1% MVC 3.8% 3.4% 4.2% 3.7% 2.8% 1.5% 3.5% 4.% 3.3% Other Assault 33.3%.%.% 8.% 7.7% 5.3% 5.9% 4.2% 5.9% Other Cause.%.% 6.3% 1.4%.%.%.%.% 1.% Other Suicide.%.% 25.%.% 25.%.% 33.3% 33.3% 2.8% Stabbing.% 2.8% 2.2% 2.2%.%.%.8%.7% 1.% Struck By/Against.% 1.9% 1.8% 4.9% 2.4% 1.1% 3.7% 2.6% 2.5% Unknown 5.2% 6.4%.%.%.%.%.% 16.7% 5.7% Grand 3.7% 3.8% 3.3% 2.9% 2.5% 2.% 3.1% 3.% 3.% 26
27 Figures Trauma Registry Records Ages 35 to 64 Years Figure Falls Figure GSW MVC Figure 34 27
28 Table 13 Trauma Registry Records Ages 35 to 64 Years TOTAL Ages 35 to 64 Years by Year and ISS YEAR ISS 1-8 ISS 9 ISS 1-15 ISS ISS >=25 Unknown Grand Grand Ages 35 to 64 Years by Year and ISS YEAR ISS 1-8 ISS 9 ISS 1-15 ISS ISS >=25 Unknown Grand Grand Percent of DTRRs with a Death Ages 35 to 64 Years YEAR ISS 1-8 ISS 9 ISS 1-15 ISS ISS >=25 Unknown Grand 25.2%.4% 2.2% 5.2% 18.%.% 2.8% 26.%.9%.% 2.% 22.3%.% 3.% 27.4%.6% 1.3% 1.5% 19.3%.% 2.4% 28.1%.5% 1.6% 4.1% 18.2%.% 2.2% 29.2%.2%.4% 2.5% 16.4%.% 1.8% 21.3%.7%.7% 1.2% 15.8%.% 1.4% 211.3% 1.8%.9% 2.9% 26.1% 5.9% 2.4% 212.2% 1.8% 2.% 4.1% 28.% 5.6% 2.4% Grand.2%.9% 1.1% 2.8% 2.1% 5.% 2.2% 28
29 Ages Greater than 64 Years 29
30 Table 14 Trauma Registry Records by Ages Greater Than 64 Years TOTAL Cause of Injury Grand Falls Fire/Burn GSW Machinery MVC Other Assault Other Cause Stabbing Struck By/Against Unknown Grand Ages Greater Than 64 Years Cause of Injury Grand Falls Fire/Burn GSW MVC Other Assault 1 1 Other Cause 1 1 Stabbing Struck By/Against Unknown Grand Percent of DTRRs with a Death Ages Greater Than 64 Years Cause of Injury Grand Falls 7.8% 6.8% 7.2% 6.9% 6.1% 5.6% 4.2% 2.6% 5.2% Fire/Burn.%.% 22.2% 27.3%.% 15.8% 14.3% 9.1% 13.5% GSW.%.% 5.% 33.3% 5.%.% 5.% 28.6% 37.9% MVC 1.2% 8.5% 12.2% 1.9% 6.1% 4.8% 4.1% 8.4% 7.4% Other Assault.%.% 1.%.%.%.%.%.% 7.1% Other Cause.%.% 3.8%.%.%.%.%.%.8% Stabbing.%.%.% 1.% 16.7%.% 8.3%.% 6.3% Struck By/Against.%.% 5.9%.%.% 23.5% 3.% 6.1% 5.6% Unknown 16.9% 14.9% 7.1% 7.1% 5.%.%.%.% 14.5% Grand 9.9% 8.3% 8.1% 7.5% 6.1% 5.8% 4.5% 3.5% 5.9% 3
31 Figures Trauma Registry Records Ages Greater Than 64 Years Falls Figure 35 Figure GSW Figure MVC
32 Table 15 Trauma Registry Records by Ages Greater Than 64 Years TOTAL Ages Greater Than 64 Years Years by Year and ISS YEAR ISS 1-8 ISS 9 ISS 1-15 ISS ISS >=25 Unknown Grand Grand Ages Greater Than 64 Years YEAR ISS 1-8 ISS 9 ISS 1-15 ISS ISS >=25 Unknown Grand Grand Percent of DTRRs with a Death Ages Greater Than 64 Years YEAR ISS 1-8 ISS 9 ISS 1-15 ISS ISS >=25 Unknown Grand 25 2.% 3.6% 1.6% 1.4% 42.5%.% 6.4% % 2.%.% 11.9% 43.8%.% 5.% % 2.5% 3.2% 8.4% 38.4%.% 3.9% % 2.5% 1.9% 6.9% 31.3%.% 3.7% 29.9% 2.6% 1.5% 4.3% 21.9%.% 2.9% % 2.4% 3.% 3.8% 22.%.% 2.9% % 2.6% 3.6% 7.5% 19.2%.% 3.% % 2.4% 2.6% 6.3% 28.1%.% 2.7% Grand 1.4% 2.5% 2.4% 7.% 29.3%.% 3.4% 32
33 Conclusion Analyses of trauma registry deaths from do not provide any evidence of a decrease in mortality rates over time. While the percentages of DTRRs with a death has decreased over time, this is due to an increase in DTRRs with low ISS s. 33
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