Trauma-related mortality in New Brunswick

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Trauma-related mortality in NB

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Introduction
 NB Trauma Program and Registry
 Project objectives
 Methods
 Results
 Conclusion

NBTP and NBTR
 NBTP manages the NBTR
 Injury admits from 8 hospitals in the NBTR
 NBTR also has more info on ISS>12 (severely injured
patients); collected from SJRH and TMH

Project objectives
 Determine undercount of mortality in the NBTR compared to
the CIHI DAD
 Determine who dies from injury, how long after discharge do
they die, and primary cause of death

Methods
 Sources of data – CIHI DAD, NBTR, and Vital Statistics (1
year of data from NBTP)
 First obtain number of trauma-related deaths from each
dataset
 Use these to determine mortality rates (per 1000 injured
people)
 Mortality rates determined for deaths that occurred in-hospital,
6 months after discharge, and up to 1 year after discharge

Methods (continued)
 Inclusion criteria (DAD) – At least one external cause of injury
code and one injury code. Eg.: an individual who met with a
bicycle accident and broke their ankle
 Exclusion – poisonings by drugs and gases, adverse effects of
drugs and biological substances
 DAD-only cohort had approx. 7500 individuals (unique
admissions). NBTR had about 2100

Methods (continued)
 Age-groups considered: 0-24, 25-39, 40-64, and 65-84
 Since # of deaths for 0-39 < what NB-IRDTdisclosure rules
allow, those age-groups are excluded here
 Observed death rate compared to expected rate by matching
with 2014 mortality rates for NB

Results
 40-64 year old patients in the DAD-only

Results (continued)
 For injured patients in the DAD-only cohort, in-hospital deaths
caused by injury was highest for the 85+ age group
 For injured patients in the NBTR, approx. half the patients who
died in-hospital had injury as primary COD
 Heart diseases and neoplasms were the predominant primary
COD for all age-groups after discharge

Conclusions and future work
 Undercount in the NBTR due to fewer injuries captured in the
registry
 Since many 40-85+ year olds died of heart conditions after
discharge, need to investigate why people (particularly 40-64
year olds) are dying and explore how risk factors are being
addressed post-discharge – will likely have policy implications
 More years of data from NBTP will allow for full disclosure and
further analyses

Project team
 Dr. Daniel Dutton
 Susan Benjamin
 Dr. Bryn Robinson
 Ian Watson

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