1. CODES and Traumatic Brain Injury Research in Kentucky Kentucky Injury Prevention and Research Center University of Kentucky School of Public Health CODES Technical Assistance Meeting Park City, UtahJune 25-27, 2001

2. Creation of TBI Data Set File Linkages Trauma Registries UB92 Death Certificates TBI Data Set Link and Remove Duplicates Filter TBI’s

3. Creation of TBI Data Set Results for 1997-1999 n 1997: 3,224 cases identified n 1998: 2,457 cases identified n 1999: linkage in progress

4. Crash-TBI Linkage 3,244 TBI’s 225,000 drivers 616 TBI cases linked to crash-involved drivers

5. Case-Control Analysis Outcome: TBI/No TBI n 616 linked Crash- TBI records n Dropped non-injury crashes from the unlinked Crash records n Randomly selected 1,232 records from the remaining Cases Controls Independent Variables n Age n Gender n Seat belt use n Urban/rural location n Type 1st harmful event n Vehicle type n Driving under the influence n Posted speed limit n Roadway condition n Weather n Impact point n Highway type

6. Selected Results Seat Belt Use n Crash-involved drivers who were reported not wearing belts had 6.6 times greater risk of TBI n Males ages 15-29 were 35% of all unbelted TBI’s but only 21% of the population of Kentucky in 1997.

7. Selected Results DUI n Crash-involved drivers who were reported as suspected DUI had 2.3 times greater risk of TBI n Males ages 15-44 were 70% TBI’s suspected DUI

8. Selected Results Urban vs. Rural Crashes n Crashes in rural areas had 1.5 times greater risk of TBI than crashes in urban areas n Collisions with fixed objects were 44% of rural TBI crashes, and to 28% of urban TBI crashes n Unsafe speed was the primary contributing human factor in 24% of rural TBI crashes, 13.5% urban. n Alcohol involvment was the primary contributing human factor in 14% of rural TBI crashes, 10% urban.

9. Selected Results Elderly Drivers n Drivers 65 and over had 1.9 times greater risk of TBI than drivers under 65 n Driver inattention and failure to yield right of way were 52% of primary contributing human factors for drivers 65 and over, and 21% for drivers under 65. n Unsafe speed and alcohol involvement were 37% of primary contributing human factors for drivers under 65, and 4.5% for drivers 65 and over.

10. Kentucky TBI Surveillance System Proposal n Kentucky crash data n Emergency department data (UB92) n Mental health and retardation n Rehabilitation n Medicaid The proposed system would incorporate the following data sets, in addition to those already being linked (hospital inpatients, death certificates, and trauma registries)