Hoopes Megan J, Dankovchik Jenine, Weiser Thomas, Cheng Tabitha, Bigback Kristyn, Knaster Elizabeth S, Sugerman David E
Northwest Tribal Epidemiology Center, Northwest Portland Area Indian Health Board, Portland, Oregon, USA.
Portland Area Indian Health Service and Northwest Tribal Epidemiology Center, Northwest Portland Area Indian Health Board, Portland, Oregon, USA.
Inj Prev. 2015 Oct;21(5):335-43. doi: 10.1136/injuryprev-2014-041419. Epub 2015 Apr 29.
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.
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.
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).
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.
本研究的目的是评估全州创伤登记处中的种族错误分类情况，并描述华盛顿州美国印第安人和阿拉斯加原住民（AI/AN）人群的创伤流行病学。
我们在华盛顿创伤登记处（2005 - 2009年）和西北部落登记处（一个已知AI/AN的数据集）之间进行了概率性记录链接。将AI/AN患者与高加索人在人口统计学、损伤和临床结局因素方面进行比较。一个多变量模型估计了死亡率的比值比。
记录链接使创伤登记处中AI/AN病例的确定率提高了71%，从1777例增加到3039例。与高加索人相比，AI/AN创伤患者更年轻（平均年龄 = 36岁对47岁，p < 0.001），男性比例更高（66.5%对61.2%，p < 0.001）。AI/AN人群遭受更多的故意伤害（自杀或他杀：20.1%对6.7%，p < 0.001），严重创伤性脑损伤的比例更高（20.7%对16.8%，p = 0.004），并且比高加索人使用安全带/安全气囊等安全设备的可能性更小（53.9%对76.7%，p <
