Texas EMS & Trauma Registries Hospital Committee September 18, 2015

Agenda Registries Overview - Reporting Rules - News - Training Updates Summary of Data Reported in 2013 Questions 2

Data Reporting Rules  Texas Administrative Code, Title 25, Part 1, Chapter 103:  Hospitals are to report submersions, traumatic brain injuries, spinal cord injuries and other traumatic injuries within 90 days of discharge  Traumatic injury—ICD-9 codes and 959.9, excluding , , and , (for ICD-10 codes see page v of the NTDB Data Dictionary) and admitted to a hospital inpatient setting (for more than 48 hours), or died after receiving any evaluation or treatment or was dead on arrival, or transferred into or out of the hospital  Submersions includes drownings and near drownings (via Web-Data Entry Only)  Registries accepts ICD-9 and ICD-10 Texas EMS & Trauma Registries 3 Injury Epidemiology & Surveillance Branch

State has adopted the national standard for EMS & Hospitals -National Trauma Data Bank (NTDB) -We anticipate accepting XML file uploads as of September 29, Will continue to accept Legacy (.txt) format until December 31, 2016 New Registries User Guide Available - Injury Severity Score (ISS) Calculator Fixed - Webinar Scheduled on October 7, 2015 Texas EMS & Trauma Registries: News 4 Texas EMS & Trauma Registries Injury Epidemiology & Surveillance Branch

Texas EMS & Trauma Registries: Training Texas EMS & Trauma Registries Injury Epidemiology & Surveillance Branch 5 Webinars (  June 10, 2015 – Hospital Web-Data Entry Training  June 24, 2015 – EMS Web-Data Entry Training  July 10, 2015 – Submersion/ISS Calculator Training  July 15, 2015 – Question/Answer/Feedback Session  July 21, 2015 – LTAC/Rehab Web-Data Entry Training  August 12, 2015 – Account Manager Training

Texas EMS & Trauma Registries: Training Upcoming webinars : 9/30 - NEMSIS Training 10/1 – NTDB Training 10/7 – ISS Calculator 10/21 – Open Session (Questions/Answers/Feedback) *Dates are subject to change

Texas EMS & Trauma Registries: Summary of 2013 Data Nina Leung, PhD Epidemologist

Trauma Hospitalizations There were 129,778 hospitalizations reported to the registry in ,884 (18.4%) reports from facilities in TSA-Q 663 fatalities Mortality Rate: 3% 8 Trauma Hospitalizations

Data Quality 9 Trauma Hospitalizations TSA-Q Hospital 2013 Data Completeness (N=23,884) Indicator% Complete Age100% Sex100% Race72% Ethnicity99% Mechanism/Intent99% Injury Severity Score93% Length of Stay100% Alcohol Use82%

Hospitalizations by Age and Sex, TSA-Q, Trauma Hospitalizations 62% of hospitalizations were male

Hospitalizations by Race and Ethnicity, TSA-Q, Trauma Hospitalizations Hispanic Ethnicity State: 30.5% TSA-Q: 29%

12 Trauma Hospitalizations ISS: Injury Severity Score Hospitalizations by ISS Categories, TSA-Q, 2013 (n=23,884)

TBI & SCI Hospitalizations by ISS Categories, TSA-Q, 2013 (N=23,884) There were 76 hospitalizations with diagnoses of TBI & SCI 89.5% of these hospitalizations had ISS ≥16 13 Trauma Hospitalizations

Hospitalizations by Median Length of Stay (LOS) and ISS Categories, TSA-Q, Trauma Hospitalizations Overall Median LOS: 2 days

Hospitalizations by Alcohol Use, TSA-Q, Trauma Hospitalizations

Cause of Injury 16 Trauma Hospitalizations Top 5 Causes of Injury, 2013 RankState#%TSA-Q#% 1.Fall60,82248%Fall9,99542% 2. Motor Vehicle/ Traffic 27,07321% Motor Vehicle/ Traffic 5,24022% 3.Struck by, against10,0178%Struck by, against2,0909% 4.Cut/ Pierce5,6734%Cut/ Pierce1,2605% 5.Transport, other5,1774%Firearm1,0905%

Intent, TSA-Q There were 2,722 Assault Injuries 38% were due to struck by, against (n=1,044) 28% were due to firearm (n=765) 18% were due to cut/pierce (n=500) There were 382 Self-Inflicted Injuries 38% were due to firearms (n=147) 34% were due to cut/pierce (n=129) 6% were due to suffocation (n=25) 17 Trauma Hospitalizations

Submersions There were 437 submersions reported to the registry in reports from entities in TSA-Q 30% fatal (n=13) 18 Submersions

19 Submersions Submersion Reporting Entity, TSA-Q Type of Entity# Submersions Reported Hospital 39 Medical Examiner 1 Justice of the Peace 4 Missing 0 Total 44

Data Quality 20 Submersions *Completeness= proportion of records with valid entry TSA-Q Submersion Data Completeness* (n=44) Indicator TSA-Q complete Age 100% Sex 100% Race 98% Ethnicity 86% Outcome 98% Scene 100% Location 89% Alcohol Use, Adults (n=9) 78% County 100% For Children (n=35) Child Supervised 97% Supervisor Age 89%

Age 21 Submersions Drownings by Age, 2013 AgeState%TSA-Q % Child (<15) % % Adult %920.45% missing/ unknown 40.92%00% Total %44100%

Drownings by Age and Sex, TSA-Q, Submersions 57% of drownings were male

Drownings by Race and Ethnicity, TSA-Q, Submersions HISPANIC Ethnicity State: 24.7% TSA-Q: 20.5%

Drownings by Month of Incident, TSA-Q, Submersions 66% occurred in June-August

Drownings by Scene of Incident, TSA-Q, 2013 SceneState%TSA-Q% Pool/ Hot tub % % Bathtub %511.36% Natural Body of Water %511.36% Other %12.27% Missing/ Unknown %920.45% Total %44100% 25 Submersions

Registry Operations Support Team (ROS) Contact Information Team Members: Adrian Conder Tiffany Munoz Jeremy Reynolds Rose Walker Judy Whitfield Telephone Voice Mail: Please contact us using one of the two methods above. The ROS Team will reply to customers within the first business day of the request. Please visit the Injury Website: 26 Injury Epidemiology & Surveillance Branch Texas EMS & Trauma Registries

Questions Texas EMS & Trauma Registries Injury Epidemiology & Surveillance Branch 27