Introduction
Methods
Data sources
Definition of traumatic brain injury and spinal cord injury
ICD codes | |
---|---|
Injury | |
TBI (Traumatic brain injury) | S01.0–S01.9, S02.0, S02.1, S02.3, S02.7–S02.9, S04.0, S06.0–S06.9, S07.0, S07.1, S07.8, S07.9, S09.7 − S09.9, T01.0, T02.0, T04.0, T06.0, T90.1, T90.2, T90.4, T90.5, T90.8, and T90.9 |
SCI (Spinal cord injury) | S12.0-S12.2, S12.7, S12.9, S13.0, S13.1, S13.4, S14.0, S14.1, S22.0, S22.1, S23.0, S23.1, S24.0, S32.0-S32.2, S32.7, S33.0, S33.1, S33.5, S33.7, S34.0, S34.1, T08.0, T09.3, T91.1 and T91.3. |
External causes for TBI and SCI | |
Motor vehicle crashes | V30–V79 [.4–.9], V81.1, V82.1, V83–V86 [.0–.3], V20–V28 [.3–.9], V29 [.4–.9], V12–V14 [.3–.9], V19 [.4–.6], V02–V04 [.1, .9], V09.2, V80 [.3–.5], V87 [.0–.8], V89.2, X82, Y03, Y32 |
Struck by and against | W20–W22, W50–W52, X79, Y00, Y04, Y29, Y35.3 |
Falls | W00–W19, X80, Y01, Y30 |
All others | the remaining ICD-10 codes for all other causes |
Road users categories | |
Vehicle occupant | V30 − V79 [.4 − .9], V81.1, V82.1, V83 − V86 [.0 − .3] |
Motorcyclist | V20 − V28 [.3 − .9], V29 [.4 − .9] |
Pedal cyclist | V12 − V14 [.3 − .9], V19 [.4 − .6] |
Pedestrian | V02 − V04 [.1, .9], V09.2 |
All others | V80 [.3 − .5], V87 [.0 − .8], V89.2 |
Statistical analyses
Results
Surveillance sample characteristics
Overall trends of TBI and SCI mortality
Characteristics | 2014 | 2015 | 2016 | 2017 | 2018 | Total | Zb | P | ||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Ratea | SE | Ratea | SE | Ratea | SE | Ratea | SE | Ratea | SE | Ratea | SE | |||
TBI | 11.6 | 0.2 | 15.4 | 0.3 | 12.3 | 0.2 | 13.2 | 0.2 | 11.9 | 0.2 | 12.9 | 0.1 | 14.2 | < 0.001 |
Sex | ||||||||||||||
Male | 16.4 | 0.4 | 22.7 | 0.4 | 17.2 | 0.4 | 17.8 | 0.4 | 16.3 | 0.4 | 18.1 | 0.2 | 31.4 | < 0.001 |
Female | 6.5 | 0.2 | 7.9 | 0.3 | 7.2 | 0.3 | 8.5 | 0.3 | 7.4 | 0.3 | 7.5 | 0.1 | −23.3 | < 0.001 |
Age group (year) | ||||||||||||||
0 ~ 4 | 5.0 | 0.6 | 7.5 | 0.8 | 3.8 | 0.5 | 4.5 | 0.6 | 4.2 | 0.5 | 5.0 | 0.3 | 18.2 | < 0.001 |
5 ~ 14 | 2.8 | 0.3 | 2.5 | 0.3 | 2.6 | 0.3 | 2.3 | 0.3 | 2.1 | 0.3 | 2.5 | 0.1 | 12.1 | < 0.001 |
15 ~ 24 | 9.1 | 0.5 | 11.2 | 0.5 | 8.6 | 0.5 | 7.9 | 0.5 | 5.8 | 0.4 | 8.5 | 0.2 | 51.6 | < 0.001 |
25 ~ 44 | 8.9 | 0.4 | 12.2 | 0.4 | 8.0 | 0.3 | 7.8 | 0.3 | 7.2 | 0.3 | 8.8 | 0.2 | 53.9 | < 0.001 |
45 ~ 64 | 14.5 | 0.5 | 21.2 | 0.6 | 15.5 | 0.5 | 16.9 | 0.5 | 15.5 | 0.5 | 16.7 | 0.2 | 9.7 | < 0.001 |
65 ~ 74 | 23.6 | 1.3 | 33.3 | 1.6 | 30.5 | 1.5 | 31.6 | 1.5 | 29.1 | 1.4 | 29.6 | 0.7 | −15.0 | < 0.001 |
≥ 75 | 48.7 | 2.2 | 52.4 | 1.9 | 66.9 | 2.6 | 87.4 | 3.0 | 80.0 | 2.9 | 67.1 | 1.1 | −79.7 | < 0.001 |
Location | ||||||||||||||
Urban | 8.0 | 0.3 | 8.0 | 0.3 | 8.1 | 0.3 | 9.0 | 0.3 | 8.2 | 0.3 | 8.2 | 0.1 | −11.7 | < 0.001 |
Rural | 15.1 | 0.4 | 23.0 | 0.4 | 16.6 | 0.4 | 17.6 | 0.4 | 15.8 | 0.3 | 17.6 | 0.2 | 25.3 | < 0.001 |
External causes | ||||||||||||||
MVC | 6.9 | 0.2 | 9.6 | 0.2 | 7.4 | 0.2 | 7.4 | 0.2 | 6.5 | 0.2 | 7.6 | 0.1 | 36.7 | < 0.001 |
Falls | 3.4 | 0.1 | 4.6 | 0.1 | 4.1 | 0.1 | 5.0 | 0.1 | 4.7 | 0.1 | 4.4 | 0.1 | −49.6 | < 0.001 |
Struck by/against | 0.7 | 0.1 | 0.4 | 0.0 | 0.3 | 0.0 | 0.4 | 0.0 | 0.2 | 0.0 | 0.4 | 0.0 | 59.5 | < 0.001 |
Others | 0.5 | 0.1 | 0.8 | 0.1 | 0.5 | 0.1 | 0.5 | 0.0 | 0.5 | 0.1 | 0.6 | 0.0 | 20.5 | < 0.001 |
SCI | 0.3 | 0.0 | 0.5 | 0.0 | 0.5 | 0.1 | 0.7 | 0.1 | 0.7 | 0.1 | 0.5 | 0.0 | −52.5 | < 0.001 |
Sex | ||||||||||||||
Male | 0.3 | 0.1 | 0.6 | 0.1 | 0.5 | 0.1 | 0.7 | 0.1 | 0.7 | 0.1 | 0.5 | 0.0 | −38.9 | < 0.001 |
Female | 0.3 | 0.1 | 0.4 | 0.1 | 0.5 | 0.1 | 0.6 | 0.1 | 0.7 | 0.1 | 0.5 | 0.0 | −35.3 | < 0.001 |
Age group (year) | ||||||||||||||
0 ~ 4 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.1 | 0.1 | 0.0 | 0.0 | 0.0 | 0.0 | −5.3 | < 0.001 |
5 ~ 14 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 11.6 | < 0.001 |
15 ~ 24 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.1 | 0.1 | 0.0 | 0.0 | −3.5 | < 0.001 |
25 ~ 44 | 0.1 | 0.0 | 0.1 | 0.0 | 0.1 | 0.0 | 0.2 | 0.1 | 0.2 | 0.1 | 0.1 | 0.0 | −10.8 | < 0.001 |
45 ~ 64 | 0.2 | 0.1 | 0.2 | 0.1 | 0.5 | 0.1 | 0.7 | 0.1 | 0.4 | 0.1 | 0.5 | 0.0 | −14.3 | < 0.001 |
65 ~ 74 | 0.7 | 0.2 | 1.2 | 0.3 | 0.6 | 0.2 | 1.0 | 0.3 | 2.0 | 0.4 | 1.1 | 0.1 | −19.1 | < 0.001 |
≥ 75 | 5.4 | 0.7 | 5.2 | 0.6 | 9.1 | 0.9 | 11.9 | 1.1 | 12.8 | 1.1 | 8.9 | 0.4 | −48.4 | < 0.001 |
Location | ||||||||||||||
Urban | 0.3 | 0.1 | 0.3 | 0.1 | 0.5 | 0.1 | 0.7 | 0.1 | 0.7 | 0.1 | 0.5 | 0.0 | −40.0 | < 0.001 |
Rural | 0.3 | 0.1 | 0.7 | 0.1 | 0.5 | 0.1 | 0.7 | 0.1 | 0.8 | 0.1 | 0.6 | 0.0 | −34.6 | < 0.001 |
External causes | ||||||||||||||
MVC | 0.1 | 0.0 | 0.1 | 0.0 | 0.1 | 0.0 | 0.1 | 0.0 | 0.1 | 0.0 | 0.1 | 0.0 | −8.8 | < 0.001 |
Falls | 0.2 | 0.0 | 0.2 | 0.0 | 0.3 | 0.0 | 0.4 | 0.0 | 0.4 | 0.0 | 0.3 | 0.0 | −39.0 | < 0.001 |
Others | 0.1 | 0.0 | 0.1 | 0.0 | 0.2 | 0.0 | 0.2 | 0.0 | 0.3 | 0.0 | 0.2 | 0.0 | −36.4 | < 0.001 |
Socio-demographic variable | TBI mortality by external cause of injury | Total TBI mortality | |||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Motor vehicle crashes | Falls | Struck by/against | All others | ||||||||||||
MRR | 95%CI | MRR | 95%CI | MRR | 95%CI | MRR | 95%CI | MRR | 95%CI | ||||||
Lower | Upper | Lower | Upper | Lower | Upper | Lower | Upper | Lower | Upper | ||||||
Sex (reference = female) | |||||||||||||||
Male | 2.5* | 2.1 | 3.0 | 2.1* | 1.8 | 2.5 | 2.2* | 1.2 | 3.9 | 2.1* | 1.3 | 3.3 | 2.3* | 2.0 | 2.6 |
Age (reference = 25 ~ 44 years) | |||||||||||||||
0 ~ 4 | 0.5* | 0.4 | 0.7 | 1.0* | 0.8 | 1.4 | 0.6* | 0.2 | 1.6 | 0.4* | 0.2 | 1.1 | 0.6* | 0.5 | 0.8 |
5 ~ 14 | 0.3* | 0.2 | 0.3 | 0.3* | 0.2 | 0.4 | 0.3* | 0.1 | 1.0 | 0.2* | 0.1 | 0.5 | 0.3* | 0.2 | 0.3 |
15 ~ 24 | 0.9* | 0.7 | 1.3 | 0.8* | 0.6 | 1.1 | 0.7* | 0.2 | 1.9 | 0.7* | 0.1 | 1.5 | 0.9* | 0.7 | 1.1 |
45 ~ 64 | 1.8* | 1.3 | 2.4 | 2.8* | 2.1 | 3.7 | 1.6* | 0.6 | 4.5 | 1.7* | 0.7 | 3.9 | 1.9* | 1.6 | 2.4 |
65 ~ 74 | 3.0* | 2.2 | 4.0 | 6.9* | 5.2 | 9.1 | 1.6* | 0.6 | 4.5 | 3.7* | 1.6 | 8.6 | 3.8* | 3.0 | 4.8 |
≥ 75 | 3.6* | 2.7 | 4.9 | 31.0* | 23.3 | 41.2 | 3.7* | 1.3 | 10.5 | 8.8* | 3.8 | 20.8 | 10.4* | 8.3 | 13.0 |
Location (reference = urban) | |||||||||||||||
Rural | 2.5* | 2.1 | 2.9 | 1.3* | 1.1 | 1.5 | 2.9* | 1.6 | 5.0 | 2.6* | 1.6 | 4.3 | 2.0* | 1.8 | 2.3 |
Year (reference = 2014) | |||||||||||||||
2015 | 1.3* | 1.0 | 1.6 | 1.2* | 1.0 | 1.6 | 0.6* | 0.3 | 1.5 | 0.8* | 0.4 | 1.6 | 1.2* | 1.0 | 1.4 |
2016 | 1.1* | 0.8 | 1.4 | 1.0* | 0.8 | 1.2 | 0.5* | 0.2 | 1.1 | 0.6* | 0.3 | 1.3 | 1.0* | 0.8 | 1.2 |
2017 | 1.1* | 0.9 | 1.5 | 1.2* | 1.0 | 1.6 | 0.6* | 0.2 | 1.4 | 0.6* | 0.3 | 1.3 | 1.1* | 0.9 | 1.3 |
2018 | 0.9* | 0.7 | 1.2 | 1.1* | 0.9 | 1.5 | 0.4* | 0.1 | 0.9 | 0.6* | 0.3 | 1.3 | 1.0* | 0.8 | 1.2 |
Socio-demographic variable | SCI mortality by external cause of injury | Total SCI mortality | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Motor vehicle crashes | Falls | Others | ||||||||||
MRR | 95%CI | MRR | 95%CI | MRR | 95%CI | MRR | 95%CI | |||||
Lower | Upper | Lower | Upper | Lower | Upper | Lower | Upper | |||||
Sex (reference = female) | ||||||||||||
Male | 5.4* | 1.4 | 23.0 | 2.5* | 1.2 | 5.1 | 1.3* | 0.4 | 4.7 | 2.2* | 1.1 | 4.7 |
Age (reference = 25 ~ 44 years) | ||||||||||||
0 ~ 4 | 0.0* | 0.0 | 0.4 | 0.0* | 0.0 | 0.0 | 0.0* | 0.0 | 0.0 | 0.0* | 0.0 | 0.1 |
5 ~ 14 | 0.1* | 0.0 | 1.1 | 0.0* | 0.0 | 0.0 | 0.0* | 0.0 | 0.0 | 0.1* | 0.0 | 0.3 |
15 ~ 24 | 0.0* | 0.0 | 0.2 | 0.0* | 0.0 | 0.0 | 0.7* | 0.1 | 6.6 | 0.1* | 0.0 | 0.4 |
45 ~ 64 | 1.5* | 0.2 | 13.2 | 4.7* | 1.9 | 11.9 | 4.6* | 0.8 | 27.3 | 3.2* | 1.0 | 10.1 |
65 ~ 74 | 3.8* | 0.4 | 38.1 | 17.3* | 6.8 | 44.8 | 23.9* | 4.0 | 146.3 | 13.9* | 4.2 | 46.0 |
≥ 75 | 3.1* | 0.3 | 29.9 | 238.0* | 86.8 | 665.6 | 188.5* | 33.7 | 1064.5 | 157.5* | 47.8 | 523.6 |
Location (reference = Urban) | ||||||||||||
Rural | 6.8* | 1.8 | 31.4 | 1.2* | 0.6 | 2.2 | 2.4* | 0.6 | 10.0 | 4.6* | 2.0 | 11.4 |
Year (reference = 2014) | ||||||||||||
2015 | 2.6* | 0.3 | 20.5 | 1.9* | 0.7 | 5.3 | 2.9* | 0.4 | 28.1 | 3.6* | 1.2 | 11.4 |
2016 | 1.2* | 0.2 | 9.3 | 1.8* | 0.7 | 5.0 | 1.5* | 0.3 | 8.6 | 1.0* | 0.3 | 2.9 |
2017 | 2.0* | 0.2 | 19.5 | 2.7* | 1.0 | 7.2 | 2.5* | 0.4 | 14.5 | 2.8* | 0.9 | 9.4 |
2018 | 4.8* | 0.6 | 44.7 | 4.1* | 1.5 | 11.2 | 2.3* | 0.4 | 13.9 | 2.0* | 0.7 | 5.6 |