Mini Oral Australian Epidemiology Association ASM 2018

Identifying prehospital fatal injuries in New Zealand using data linkage (#11)

Rebbecca Lilley 1 , Bridget Kool 2 , Gabrielle Davie 1 , Brandon de Graaf 1 , Shanthi Ameratunga 2 , Papaarangi Reid 2 , Ian Civil 2 , Bridget Dicker 2 , Charles Branas 3
  1. Injury Prevention Research Centre, University of Otago, Dunedin, OTAGO, New Zealand
  2. University of Auckland, Auckland, New Zealand
  3. Department of Epidemiology, Columbia University, New York, NY, United States of America

Background: Trauma-related injuries are a common cause of mortality globally. There has been little examination of prehospital fatalities (deaths occurring either at the scene of the injury event or en route to hospital) and the identification of prevention opportunities in the prehospital setting to prevent trauma-related fatalities in New Zealand. 

Aims: To determine the patterns of prehospital injury deaths in New Zealand for the period 2008-2012.

Methods: All deaths registered in 2008-2012 with an underlying cause of death International Classification of Injury (ICD-10) external cause code within V01-Y36 were selected from the Mortality Collection and linked to both hospital discharge data and Coronial case files extracted from National Coronial Information System (NCIS). Hospital discharge data and Coronial case files were used to identify if cases died either in the hospital or prehospital setting.  Information regarding the demographic characteristics of the decedents, and the injury circumstances was extracted.

Results: 7004 injury deaths were identified from the Mortality Collection and had Coronial case files available on NCIS. Linkage identified the majority of deaths occurred in the pre-hospital setting (n=5791, 82%).  The highest rates of pre-hospital fatal injury occurred in adolescents (16-24 yrs), males, Indigenous Maori and caused by suffocation or transport-related injury mechanisms.

Discussion & conclusions: Linkage identified the major burden of fatal injury in New Zealand occur in the prehospital setting. Understanding the distribution of prehospital mortality key step in identifying opportunities for primary prevention and possible secondary previous including improved care in advanced trauma system & bystander interventions.