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Addendum to Injury Morbidity and Mortality in Indiana

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Addendum to Injury Morbidity and Mortality in Indiana. Injury Prevention Advisory Council Meeting June 21, 2012 Julie Wirthwein— Injury Prevention Epidemiologist. Division of Trauma and Injury Prevention. Overview. Background of State Injury Indicators Report - PowerPoint PPT Presentation
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A healthier and safer Indiana ADDENDUM TO INJURY MORBIDITY AND MORTALITY IN INDIANA Injury Prevention Advisory Council Meeting June 21, 2012 Julie Wirthwein—Injury Prevention Epidemiologist DIVISION OF TRAUMA AND INJURY PREVENTION
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Page 1: Addendum to Injury Morbidity and Mortality in Indiana

A healthier and safer Indiana

ADDENDUM TO INJURY MORBIDITY AND MORTALITY IN INDIANA

Injury Prevention Advisory Council MeetingJune 21, 2012

Julie Wirthwein—Injury Prevention Epidemiologist

DIVISION OF TRAUMA AND INJURY PREVENTION

Page 2: Addendum to Injury Morbidity and Mortality in Indiana

Overview

Background of State Injury Indicators ReportInjury mortality, hospitalization and emergency department (ED)

dataInjury by intentFall-related injuries by typeFire and hot object/substance injuriesMotor vehicle crash injuries by injured person typeCauses/mechanisms of traumatic brain injuriesLeading causes of injury death by age group

2

Page 3: Addendum to Injury Morbidity and Mortality in Indiana

Data Sources

Indiana Mortality Reports (http://www.in.gov/isdh/19096.htm)

Published by: Indiana State Department of Health (ISDH), Data Analysis Team (DAT)

Hospital Discharge Datasets (HDD), Inpatient and Emergency Department (ED) Overseen by: ISDH, DAT; Indiana Hospital Association

Web-based Injury Statistics Query and Reporting System (WISQARS) (http://www.cdc.gov/injury/wisqars/index.html)

Centers for Disease Control and Prevention, 2006–2009

3

Page 4: Addendum to Injury Morbidity and Mortality in Indiana

State Injury Indicators

An injury indicator describes a health outcome of an injury, such as a hospitalization or death, or a factor known to be associated with an injury, such as a risk or protective factor among a specified population

Guidelines for injury surveillance developed by the State and Territorial Injury Prevention Directors Association (STIPDA) and the Council of State and Territorial Epidemiologists (CSTE)

Provides state injury programs with a standardized method for evaluating injury data that is comparable across states, the United States and territories

4

Page 5: Addendum to Injury Morbidity and Mortality in Indiana

State Injury Indicators—Injury Categories

Causes of InjuryUnintentional Drowning

(Drowning)Unintentional Fall-related (Falls)Unintentional Fire-related (Fire)Firearm-relatedHomicide/AssaultPoisoningMotor Vehicle TrafficSuicide/Suicide Attempt

5

Types of Injury Traumatic Brain Injury (TBI) Hip Fracture Admissions, aged

65 years and older

Page 6: Addendum to Injury Morbidity and Mortality in Indiana

State Injury Indicators

Overlaps exist among injury categories Example: A firearm-related homicide could be included in the

firearm-related, homicide and traumatic brain injury (TBI) death indicator totals

Mortality data include only Indiana residents whether or not the death occurred in-state

HDD characteristics Restricted to non-federal, non-state, acute care facilities No psychiatric, rehab, or long-term hospitals are included Readmissions, transfers, and in-hospital deaths are included

6

Page 7: Addendum to Injury Morbidity and Mortality in Indiana

Injury Coding

Mortality Data: International Classification of Disease, Tenth Revision (ICD-10), (See Appendix A)

Hospital Discharge Data: International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM), (See Appendix B) External causes of injury and poisoning codes (E-codes)

• Capture how the injury or poisoning happened (cause), the intent (unintentional, intentional, undetermined), and the place where the event occurred

• Are intended to provide data for injury research and evaluation of injury prevention strategies

• Quality of data is dependent on the completeness and accuracy of E-codes• Indiana’s E-code percentage (Inpatient HDD) in 2009: 62.44%

Injury Hospitalization and Emergency Department Subsets were produced by searching principal diagnosis field for appropriate codes

7

Page 8: Addendum to Injury Morbidity and Mortality in Indiana

Overview of Mortality Data—Indiana, 2007–2009

Death rate for all injuries combined was 60.0 deaths per 100,000 from 2007 to 2009, claiming 11,640 lives

Males were 2.4 times more likely than females to be fatally injured (86.2 versus 35.5 per 100,000)

Injury death rates were highest among those aged 85 years and older (286.1 per 100,000)

8

Source: ISDH, Epidemiology Resource Center, DAT

Page 9: Addendum to Injury Morbidity and Mortality in Indiana

Overview of Mortality Data—Indiana, 2007–2009

Leading causes of injury deaths among both sexes combined were poisonings (15.0 per 100,000), suicides (12.5 per 100,000), and motor vehicle crashes (12.3 per 100,000)

Leading causes of injury deaths among males were suicides (20.8 per 100,000), firearm-related incidents (19.4 per 100,000), and poisonings (18.8 per 100,000)

Leading causes of injury deaths among females were poisonings (11.2 per 100,000), motor vehicle crashes (6.9 per 100,000), and suicides (4.8 per 100,000)

9

Source: ISDH, Epidemiology Resource Center, DAT

Page 10: Addendum to Injury Morbidity and Mortality in Indiana

Overview of Inpatient Hospital Discharge Data—Indiana, 2007–2009 Leading causes of injury-related hospitalizations among both

sexes combined were falls (163.2 per 100,000), poisonings (68.8 per 100,000), and motor vehicle crashes (45.2 per 100,000)

Males were 1.1 times more likely than females to be hospitalized because of an injury (496.8 versus 468.7 per 100,000)

10

Source: ISDH, Epidemiology Resource Center

Page 11: Addendum to Injury Morbidity and Mortality in Indiana

Overview of Inpatient Hospital Discharge Data—Indiana, 2007–2009 Leading causes of injury-related hospitalizations among males

were falls (134.7 per 100,000), poisonings (62.1 per 100,000), and motor vehicle crashes (57.5 per 100,000)

Leading causes of injury-related hospitalizations among females were falls (178.6 per 100,000), poisonings (75.4 per 100,000), and suicides (47.2 per 100,000)

11

Source: ISDH, Epidemiology Resource Center

Page 12: Addendum to Injury Morbidity and Mortality in Indiana

Overview of ED Hospital Discharge Data—Indiana, 2007–2009 Leading causes of injury-related ED visits among both sexes

combined were falls (1,900.5 per 100,000), motor vehicle crashes (604.2 per 100,000), and assaults (248.8 per 100,000)

Males were 1.1 times more likely than females to visit an ED because of an injury (9,407.3 versus 8,204.4 per 100,000)

12

Source: ISDH, Epidemiology Resource Center

Page 13: Addendum to Injury Morbidity and Mortality in Indiana

Overview of ED Hospital Discharge Data—Indiana, 2007–2009 Leading causes of injury ED visits among males were falls

(1,730.3 per 100,000), motor vehicle crashes (566.2 per 100,000), and assaults (302.8 per 100,000)

Leading causes of injury ED visits among females were falls (2,035.3 per 100,000), motor vehicle crashes (643.3 per 100,000), and assaults (193.4 per 100,000)

13

Source: ISDH, Epidemiology Resource Center

Page 14: Addendum to Injury Morbidity and Mortality in Indiana

Overview of ED Hospital Discharge Data—Indiana, 2007–2009 Leading causes of injury ED visits among males were falls

(1,730.3 per 100,000), motor vehicle crashes (566.2 per 100,000), and assaults (302.8 per 100,000)

Leading causes of injury ED visits among females were falls (2,035.3 per 100,000), motor vehicle crashes (643.3 per 100,000), and assaults (193.4 per 100,000)

14

Source: ISDH, Epidemiology Resource Center

Page 15: Addendum to Injury Morbidity and Mortality in Indiana

Injury Fatality ICD-10 Codes

15

V01–Y36Y85–Y87Y89

Injury and poisoning

Page 16: Addendum to Injury Morbidity and Mortality in Indiana

Overview of Injury Death Rates—Indiana, 2007–2009

16

<1 1-45-14

15-2425-34

35-4445-54

55-6465-74

75-84 85+0

50100150200250300350400

By Age and Sex

Males Females

Age Group (years)

Rate

per

100

,000

Fire

Drowning Fall

Homicide

Firear

m

Motor Veh

icle

Suicid

e

Poisoning TB

I02468

1012141618

1.2 1.2

4.9 5.5

11.012.3 12.5

15.016.4

By Cause/Type*

Rate

per

100

,000

Fire

Drowning Fall

Homicide

Poisoning

Firear

m

Motor Veh

icle

Suicid

es TBI

0

5

10

15

20

25

30By Cause/Type and Sex*

Males Females

Rate

per

100

,000

Males Females0

102030405060708090

10086.2

35.5

By Sex*

Rate

per

100

,000

*Age-adjusted

Page 17: Addendum to Injury Morbidity and Mortality in Indiana

Age-Adjusted Injury Death Rates by Cause/Type—Indiana, 2007–2009

17

Fire

DrowningFa

ll

Homicide

Firearm

Motor Vehicl

e

Suici

de

Poisoning TBI

02468

1012141618

1.2 1.2

4.9 5.5

11.012.3 12.5

15.016.4

Rate

per

100

,000

Source: ISDH, Epidemiology Resource Center, DAT

Page 18: Addendum to Injury Morbidity and Mortality in Indiana

18

Fire

DrowningFa

ll

Homicide

Poisoning

Firearm

Motor Vehicl

e

Suici

desTBI

0

5

10

15

20

25

30

1.4 1.9

6.78.1

18.8 19.417.9

20.8

26

0.9 0.5

3.6 2.8

11.2

3.2

6.94.8

7.7

Males Females

Rate

per

100

,000

Source: ISDH, Epidemiology Resource Center, DAT

Age-Adjusted Injury Death Rates by Sex and Cause/Type—Indiana, 2007–2009

Page 19: Addendum to Injury Morbidity and Mortality in Indiana

19

Males Females0

10

20

30

40

50

60

70

80

90

100

86.2

35.5

Rtae

per

100

,000

Source: ISDH, Epidemiology Resource Center, DAT

Age-Adjusted Injury Death Rates by Sex—Indiana, 2007–2009

Page 20: Addendum to Injury Morbidity and Mortality in Indiana

20

<1 1-45-14

15-2425-34

35-4445-54

55-6465-74

75-8485+

0

50

100

150

200

250

300

350

400

Males Females

Age Group (years)

Rate

per

100

,000

Source: ISDH, Epidemiology Resource Center, DAT

Injury Death Rates by Sex and Age—Indiana, 2007–2009

Page 21: Addendum to Injury Morbidity and Mortality in Indiana

Hospitalizations for All Injuries ICD-9-CM Codes

21

800–909.2909.4909.9–994.9995.5–995.59995.80–995.85

Injury and poisoning

Page 22: Addendum to Injury Morbidity and Mortality in Indiana

DrowningFir

e

Firear

m

Homicide/A

ssault

Suicid

e

Motor Veh

icle

TBI

Poisoning Fal

l0

20406080

100120140160180

0.5 3.6 6.0 12.4

40.8 45.264.0 68.8

163.2

By Cause/Type*

Rate

per

100

,000

Fire

Drowning Fall

Assault

Poisoning

Firear

m

Motor Veh

icle

Suicid

e TBI

020406080

100120140160180200

By Cause/Type and Sex*

Males Females

Rate

per

100

,000

Males Females0

100

200

300

400

500

600496.8 468.7

By Sex*

Rate

per

100

,000

*Age-adjusted

<1 1-4 5-14 15-24

25-34

35-44

45-54

55-64

65-74

75-84

85+0

1,000

2,000

3,000

4,000

5,000

6,000By Age and Sex

Males Females

Age Group (years)

Rate

per

100

,000

Overview of Injury Hospitalization Rates—Indiana, 2007–2009

22

Page 23: Addendum to Injury Morbidity and Mortality in Indiana

DrowningFir

e

Firearm

Homicide/A

ssault

Suici

de

Motor Vehicl

e TBI

Poisoning

Fall

020406080

100120140160180

0.5 3.6 6.0 12.4

40.8 45.264.0 68.8

163.2

Rate

per

100

,000

Age-Adjusted Injury Hospitalization Rates by Cause/Type—Indiana, 2007–2009

23

Source: ISDH, Epidemiology Resource Center

Page 24: Addendum to Injury Morbidity and Mortality in Indiana

Fire

DrowningFa

ll

Assault

Poisoning

Firearm

Motor Vehicl

e

Suici

de TBI0

20406080

100120140160180200 Males Females

Rate

per

100

,000

Age-Adjusted Injury Hospitalization Rates by Sex and Cause/Type—Indiana, 2007–2009

24

Source: ISDH, Epidemiology Resource Center

Page 25: Addendum to Injury Morbidity and Mortality in Indiana

Males Females0

100

200

300

400

500

600

496.8468.7

Rate

per

100

,000

Age-Adjusted Injury Hospitalization Rates by Sex—Indiana, 2007–2009

25

Source: ISDH, Epidemiology Resource Center

Page 26: Addendum to Injury Morbidity and Mortality in Indiana

<1 1-4 5-1415-24

25-3435-44

45-5455-64

65-7475-84 85+

0

1,000

2,000

3,000

4,000

5,000

6,000Males Females

Age Group (years)

Rate

per

100

,000

Injury Hospitalization Rates by Age and Sex—Indiana, 2007–2009

26

Source: ISDH, Epidemiology Resource Center

Page 27: Addendum to Injury Morbidity and Mortality in Indiana

ED Visits for All Injuries ICD-9-CM Codes

27

800–909.2909.4909.9–994.9995.5–995.59995.80–995.85

Injury and poisoning

Page 28: Addendum to Injury Morbidity and Mortality in Indiana

Drowning

Firear

m Fire

Suicid

e

Poisoning

Assault TB

I

Motor Veh

icle

Fall

0250500750

1,0001,2501,5001,7502,000

1.5 11.3 24.2 68.4 140.2 248.8486.4

604.2

1,900.5By Cause/Type*

Rate

per

100

,000

Fire

Drowning Fall

Assault

Poisoning

Firear

m

Motor Veh

icle

Suicid

es TBI

0250500750

1,0001,2501,5001,7502,0002,250

By Cause/Type and Sex*

Males Females

Rate

per

100

,000

<1 1-4 5-14 15-24

25-34

35-44

45-54

55-64

65-74

75-84

85+0

2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000By Age and Sex

Males Females

Age Group (years)

Rate

per

100

,000

Overview of Injury ED Visit Rates—Indiana, 2007–2009

28

*Age-adjusted

Page 29: Addendum to Injury Morbidity and Mortality in Indiana

Drowning

Firearm Fir

e

Suici

de

Poisoning

Assault TBI

Motor Vehicl

e Fa

ll0

250

500

750

1,000

1,250

1,500

1,750

2,000

1.5 11.3 24.2 68.4 140.2248.8

486.4604.2

1,900.5

Rate

per

100

,000

Age-Adjusted Injury ED Visit Rates by Cause/Type—Indiana, 2007–2009

29

Source: ISDH, Epidemiology Resource Center

Page 30: Addendum to Injury Morbidity and Mortality in Indiana

Fire

Drowning Fall

Assault

Poisoning

Firearm

Motor Vehicle

Suicides TBI0

250

500

750

1,000

1,250

1,500

1,750

2,000

2,250MalesFemales

Rate

per

100

,000

Age-Adjusted Injury ED Visit Rates by Cause/Type and Sex—Indiana, 2007–2009

30

Source: ISDH, Epidemiology Resource Center

Page 31: Addendum to Injury Morbidity and Mortality in Indiana

<1 1-4 5-1415-24

25-3435-44

45-5455-64

65-7475-84

85+0

2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000 Males Females

Age Group (years)

Rate

per

100

,000

Injury ED Visit Rates by Age and Sex—Indiana, 2007–2009

31

Source: ISDH, Epidemiology Resource Center

Page 32: Addendum to Injury Morbidity and Mortality in Indiana

Injury Deaths by Intent—Indiana, 2007–2009

32

65.1%

29.6%

5.2%

0.2%

Unintentional

Intentional

Undetermined

Other

N=11,643

Source: ISDH, Epidemiology Resource Center, DAT

Page 33: Addendum to Injury Morbidity and Mortality in Indiana

Intentional Injury Deaths by Type—Indiana, 2007–2009

33

70.0%

30.0%

Suicide

Assault/Homicide

N=3,447

Source: ISDH, Epidemiology Resource Center, DAT

Page 34: Addendum to Injury Morbidity and Mortality in Indiana

34

82.2%

14.7%

3.0% 0.1%

Unintentional

Intentional

Undetermined

Other

Injury Hospitalizations by Intent—Indiana, 2007–2009

N=68,041

Source: ISDH, Epidemiology Resource Center

Page 35: Addendum to Injury Morbidity and Mortality in Indiana

Intentional Injury Hospitalizations by Type—Indiana, 2007–2009

35

76.8%

23.2%

Self-Inflicted

Assault

N=10,009

Source: ISDH, Epidemiology Resource Center

Page 36: Addendum to Injury Morbidity and Mortality in Indiana

Unintentional Fall-Related Deaths by Type—Indiana, 2007–2009

36

54.8%

17.2%

9.7%

7.1%

3.5%

3.1% 2.4% 2.3%Unspecified falls

Other slipping, tripping and stumbling

Stairs or steps

Other, specified

Out of or through building or structure

Ladder or scaffolding

Other fall from one level to another

Same level from slipping, tripping and stumbling

N=1,008

Source: ISDH, Epidemiology Resource Center, DAT

Page 37: Addendum to Injury Morbidity and Mortality in Indiana

37

42.3%

33.6%

10.8%

7.8%

3.4% 1.4% 0.3% 0.3%

Other and unspecified

Same level from slipping, tripping, or stumbling

One level to another

Stairs or steps

Ladders or scaffolding

Building or other structure

Hole or other opening in surface

Same level from collision, pushing, or shoving

Unintentional Fall-Related Hospitalizations by Type—Indiana, 2007–2009

N=32,912Source: ISDH, Epidemiology Resource Center

Page 38: Addendum to Injury Morbidity and Mortality in Indiana

38

38.2%

32.7%

14.7%

10.1%

2.3% 0.9% 0.7% 0.4%

Other and unspecified

Same level from slipping, tripping, or stumbling

One level to another

Stairs or steps

Ladders or scaffolding

Same level from collision, push-ing, or shoving

Hole or other opening in surface

Building or other structure

Unintentional Fall-Related ED Visits by Type—Indiana, 2007–2009

N=364,498

Source: ISDH, Epidemiology Resource Center

Page 39: Addendum to Injury Morbidity and Mortality in Indiana

Fire/Burn* Hospitalizations—Indiana, 2007–2009

39

50.1%49.9% Fire/flame

Hot object/substance*

*Hot object/substance burns excluded from State Injury Indicators Report

N=1,370

Source: ISDH, Epidemiology Resource Center

Page 40: Addendum to Injury Morbidity and Mortality in Indiana

40

*Hot object/substance burns excluded from State Injury Indicators Report

Fire/Burn* ED Visits—Indiana, 2007–2009

N=20,26777.5%

22.5%

Hot object/substance*

Fire/flame

Source: ISDH, Epidemiology Resource Center

Page 41: Addendum to Injury Morbidity and Mortality in Indiana

Motor Vehicle Crash Deaths by Injured Person Type—Indiana, 2007–2009

41

N=2,364

Source: ISDH, Epidemiology Resource Center, DAT

51.0%

23.9%

12.3%

7.3%

3.7% 1.4% <1%

Unspecified, other land transport

Car occupant

Motorcyclist

Pedestrian

Occupant of pick-up truck or van

Pedal Cyclist

Occupant of heavy transport vehicle

Bus occupant

Page 42: Addendum to Injury Morbidity and Mortality in Indiana

42

Motor Vehicle Crash Hospitalizations by Injured Person Type—Indiana, 2007–2009

N=8,639

48.4%

19.1%

17.8%

7.1%

4.2%2.0% 1.4%

Driver

Passenger

Motorcyclist

Pedestrian

Unspecified

Pedal Cyclist

Passenger on Motorcycle

Source: ISDH, Epidemiology Resource Center

Page 43: Addendum to Injury Morbidity and Mortality in Indiana

43

Motor Vehicle Crash ED Visits by Injured Person Type—Indiana, 2007–2009

N=113,553

55.9%

24.4%

8.5%

6.2%

3.3%1.4%<1%

Driver

Passenger

Unspecified

Motorcyclist

Pedestrian

Pedal Cyclist

Passenger on Motorcycle

Source: ISDH, Epidemiology Resource Center

Page 44: Addendum to Injury Morbidity and Mortality in Indiana

Causes/Mechanisms of TBI Deaths—Indiana, 2009

44

Cause/Mechanism* TBI (N=1,012)

Falls 209

Fire 1

Firearms 453

Homicide 111

MVT 202

Poisoning 2

Suicide 360

Cause/Mechanism* TBI (%)

Falls 20.7%

Fire 0.1%

Firearms 44.8%

Homicide 11.0%

MVT 20.0%

Poisoning 0.2%

Suicide 35.6%

*Causes/mechanisms not mutually exclusive

Source: ISDH, Epidemiology Resource Center, DAT

Page 45: Addendum to Injury Morbidity and Mortality in Indiana

45

Firearm-Related TBI Deaths by Selected Cause—Indiana, 2009

Source: ISDH, Epidemiology Resource Center, DAT

Cause

Firearm-Related TBI

(N=452)Suicide by Discharge of Firearms 355Homicide by Discharge of Firearms 78Accidental Discharge of Firearms 14

Undetermined Discharge of Firearms 5

Cause

Firearm-Related TBI

(%)Suicide by Discharge of Firearms 78.4%Homicide by Discharge of Firearms 17.2%Accidental Discharge of Firearms 3.1%

Undetermined Discharge of Firearms 1.1%

Page 46: Addendum to Injury Morbidity and Mortality in Indiana

Causes/Mechanisms of TBI Hospitalizations—Indiana, 2009

46

Cause/Mechanism* TBI (N=4,245)

Falls 1,618

Fire 4

Firearms 59

Homicide 230

MVT 935

Poisoning 27

Suicide 33

Cause/Mechanism* TBI (%) †

Falls 38.1%

Fire 0.1%

Firearms 1.4%

Homicide 5.4%

MVT 22.0%

Poisoning 0.6%

Suicide 0.8%

Source: ISDH, Epidemiology Resource Center

*Causes/mechanisms not mutually exclusive† Total less than 100% due to lack of e-codes and other unlisted causes/mechanisms (TBI e-code percentage: 76.1%)

Page 47: Addendum to Injury Morbidity and Mortality in Indiana

47

Source: WISQARS

*Note change in years

Death Rates among Children Under Age One Year by Mechanism of Injury—Indiana and United States, 2000–2009*

Drowning

Poisoning

Motor Vehicle

Homicide

Unintentional Suffocation

0 10 20 30 40 50 60

1.4

0.9

3.2

8.0

18.6

1.7

1.4

2.4

10.1

40.4

IN US

Rate per 100,000

Page 48: Addendum to Injury Morbidity and Mortality in Indiana

48

Source: WISQARS

Death Rates among Children Ages 1–4 Years by Mechanism of Injury—Indiana and United States, 2000–2009

Unintentional Suffocation

Fire

Motor Vehicle

Drowning

Homicide

0 1 2 3 4 5

0.9

1.3

3.0

2.8

2.4

1.4

2.0

3.2

3.0

3.9

INUS

Rate per 100,000

Page 49: Addendum to Injury Morbidity and Mortality in Indiana

49

Firearm

Suicide

Fire

Homicide

Motor Vehicle

0 1 2 3 4 5

0.8

0.6

0.5

0.8

3.2

0.8

0.7

0.7

1.1

3.3

INUS

Rate per 100,000

Source: WISQARS

Death Rates among Children Ages 5–14 Years by Mechanism of Injury—Indiana and United States, 2000–2009

Page 50: Addendum to Injury Morbidity and Mortality in Indiana

50

Homicide

Suicide

Poisoning

Firearm

Motor Vehicle

0 5 10 15 20 25 30

12.2

9.9

8.9

15.4

20.5

9.6

10.8

12.3

14.5

19.6

INUS

Rate per 100,000

Source: WISQARS

Death Rates among 15–24 Year Olds by Mechanism of Injury—Indiana and United States, 2007–2009

*Note change in years

Page 51: Addendum to Injury Morbidity and Mortality in Indiana

51

Homicide

Suicide

Motor Vehicle

Firearm

Poisoning

0 5 10 15 20 25 30

11.1

12.9

15.3

15.0

18.0

11.9

15.3

16.2

17.7

24.1

IN

US

Rate per 100,000

Source: WISQARS

Death Rates among Adults Ages 25–34 Years by Mechanism of Injury—Indiana and United States, 2007–2009

Page 52: Addendum to Injury Morbidity and Mortality in Indiana

52

Homicide

Firearm

Motor Vehicle

Suicide

Poisoning

0 5 10 15 20 25 30

6.9

11.9

13.0

15.9

23.2

6.4

13.1

13.3

18.9

27.0

IN US

Rate per 100,000

Source: WISQARS

Death Rates among Adults Ages 35–44 Years by Mechanism of Injury—Indiana and United States, 2007–2009

Page 53: Addendum to Injury Morbidity and Mortality in Indiana

53

Homicide

Motor Vehicle

Firearm

Suicide

Poisoning

0 5 10 15 20 25 30

4.8

13.3

11.5

18.6

28.3

4.2

13.6

13.4

19.2

27.9

IN US

Rate per 100,000

Source: WISQARS

Death Rates among Adults Ages 45–54 Years by Mechanism of Injury—Indiana and United States, 2007–2009

Page 54: Addendum to Injury Morbidity and Mortality in Indiana

54

Fall

Firearm

Motor Vehicle

Poisoning

Suicide

0 2 4 6 8 10 12 14 16 18 20

5.4

10.7

12.1

15.3

16.2

4.2

11.4

11.9

14.3

16.0

INUS

Rate per 100,000

Source: WISQARS

Death Rates among Adults Ages 55–64 Years by Mechanism of Injury—Indiana and United States, 2007–2009

Page 55: Addendum to Injury Morbidity and Mortality in Indiana

55

Poison-ing

Fall

Firearm

Motor Vehicle

Suicide

0 5 10 15 20 25 30

5.7

13.6

10.7

13.2

13.5

5.4

10.6

12.0

12.4

14.5

IN US

Rate per 100,000Source: WISQARS

Death Rates among Adults Ages 65–74 Years by Mechanism of Injury—Indiana and United States, 2007–2009

Page 56: Addendum to Injury Morbidity and Mortality in Indiana

56

Poisoning

Firearm

Suicide

Motor Vehicle

Fall

0 10 20 30 40 50 60

4.7

13.1

15.9

18.5

51.9

5.1

14.5

16.5

20.0

35.7

INUS

Rate per 100,000

Source: WISQARS

Death Rates among Adults Ages 75–84 Years by Mechanism of Injury—Indiana and United States, 2007–2009*

Page 57: Addendum to Injury Morbidity and Mortality in Indiana

57

Fire

Firearm

Suicide

Motor Vehicle

Fall

0 20 40 60 80 100 120 140 160 180 200

4.4

12.0

15.8

20.6

182.1

4.4

10.2

12.0

18.7

116.2

INUS

Rate per 100,000

Source: WISQARS

Death Rates among Adults Ages 85+ Years by Mechanism of Injury—Indiana and United States, 2007–2009

Page 58: Addendum to Injury Morbidity and Mortality in Indiana

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Page 59: Addendum to Injury Morbidity and Mortality in Indiana

59

Unintentional Poisoning

Unintentional MV Traffic

Suicide Firearm

Unintentional Fall

Homicide Firearm

-100% 0% 100% 200% 300% 400% 500% 600%

501.5%

-30.8%

13.9%

22.5%

-11.1%

*Age-adjusted rates

Source: WISQARS

Percent Change in Leading Causes of Injury Death*— Indiana, 1999–2009

Page 60: Addendum to Injury Morbidity and Mortality in Indiana

Leading Causes of Injury Death*—Indiana, 1999–2009

60

0

2

4

6

8

10

12

14

16

18

2.06

12.39

15.47

10.71

6.1

6.95

4.355.33

4.4 3.91

Unintentional Poisoning

Unintentional MV Traffic

Suicide Firearm

Unintentional Fall

Homicide Firearm

Year

Rate

per

100

,000

*Age-adjusted rates

Source: WISQARS

Page 61: Addendum to Injury Morbidity and Mortality in Indiana

61

Conclusions

Leading causes of injury mortality among all ages combined: Unintentional Poisoning Suicide Motor Vehicle Crashes

Leading causes of injury hospitalization and ED visits among all ages combined: Falls Unintentional Poisoning Motor Vehicle Crashes Assault

Page 62: Addendum to Injury Morbidity and Mortality in Indiana

62

Diagnosis Code

V01–Y36, Y85–Y87, Y89 All Injury and Poisoning

W65–W74, V90, V92 Unintentional Drowning

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, T90.1, T90.2, T90.4, T90.5, T90.8, T90.9

Traumatic Brain Injury (TBI)

X40–X49, X60–X69, X85–X90, Y10–Y19, Y35.2 Poisoning

V02–V04 (.1, .9), V09.2, V12–V14 (.3–.9), V19 (.4–.6), V20–V28 (.3–.9), V29 (.4–.9), V30–V39 (.4–.9), V40–V49 (.4–.9), V50–V59 (.4–.9), V60–V69 (.4–.9), V70–V79 (.4–.9), V80 (.3-.5), V81.1, V82.1, V83–V86 (.0-.3), V87 (.0–.8), V89.2

Motor Vehicle Traffic

X60–X84, Y87.0 Suicide

W32–W34, X72–X74, X93–X95, Y22–Y24, Y35.0 Firearm-related

X85–Y09, Y87.1 Homicide

W00–W19 Unintentional Falls

X00–X09 Unintentional Fire

Appendix AInjury Fatality ICD-10 Codes

Page 63: Addendum to Injury Morbidity and Mortality in Indiana

Appendix BInjury Hospitalization and ED Visit Codes

Principal Diagnosis

800–909.2, 909.4, 909.9–994.9, 995.5–995.59, 995.80–995.85

All Injury and Poisoning

994.1 Drowning

820 Hip Fracture

800.00–801.99, 803.00–804.99, 850.0–850.9, 851.00–854.19, 950.1–950.3, 959.01, 995.55

Traumatic Brain Injury (TBI)

E-Code

E850–E858, E860–E869, E950–E952, E962, E972, E980–E982, E979 (.6–.7)

Poisoning

E810–E819 Motor Vehicle Traffic

E950–E959 Suicide Attempt

E922.0–E922.3, E922.8, E922.9, E955.0–E955.4, E965.0–E965.4, E985.0–E985.4, E970, E979.4

Firearm-related

E960–E969, E979, E999.1 Assault

E880–E886, E888 Unintentional Falls

E890–E899 Unintentional Fire

63


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