Mortality in rural locations after severe injuries from motor vehicle crashes |
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| Authors: | Lori L Travis David E Clark Amy E Haskins Joseph A Kilch |
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| Institution: | 1. Centre of Study and Research on Road Safety, Section of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine, Via Forlanini 2, 27100 Pavia, Italy;2. Unit of Epidemiology & Medical Statistics, Department of Public Health and Community Medicine, University of Verona, Istituti Biologici, Blocco B, Strada Le Grazie 8, 37134 Verona, Italy;1. Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Ochsner Medical Center, New Orleans, LA;2. Department of Urology, University of Pittsburgh Physicians, Pittsburgh, PA;3. Johns Hopkins Bayview Medical Center, James Buchanan Brady Urological Institute, Johns Hopkins School of Medicine, Baltimore, MD;4. Department of Surgery, Johns Hopkins Bayview Medical Center, Johns Hopkins School of Medicine, Baltimore, MD;5. Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD;6. Department of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, MD;7. Department of Surgery, Johns Hopkins Quality and Safety Research Group, Johns Hopkins School of Medicine, Baltimore, MD;8. James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, MD;9. Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, MD;1. Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX;2. American Board of Surgery, Philadelphia, PA |
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| Abstract: | BackgroundMortality from traffic crashes is often higher in rural regions, and this may be attributable to decreased survival probability after severe injury.MethodsData were obtained from the National Automotive Sampling System – General Estimates System (NASS-GES) for 2002–2008. Using weighted survey logistic regression, three injury outcomes were analyzed: (a) Death overall, (b) Severe injury (incapacitating or fatal), and (c) Death, after severe injury. Models controlled for (pre-crash) person, event, and county level factors.ResultsThe sample included 883,473 motorists. Applying weights, this represented a population of 98,411,993. Only 2% of the weighted sample sustained a severe injury, and 9% of these severely injured motorists died. The probability of death overall and the probability of severe injury increased with older age, safety belt nonuse, vehicle damage, high speed, and early morning crashes . Males were less likely to be severely injured, but more likely to die if severely injured. Motorists in southern states were more likely to have severe injuries, but not more likely to die if severely injured. Motorists who crashed in very rural counties were significantly more likely to die overall, and were more likely to die if severely injured.ConclusionsMotorists with severe injury are more likely to die in rural areas, after controlling for person- and event-specific factors. |
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