Evaluating adverse rural crash outcomes using the NHTSA State Data System.
Evaluating adverse rural crash outcomes using the NHTSA State Data System.
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DOI：
10.1016/j.aap.2015.06.005
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发表时间：
2015-09
期刊：
影响因子：
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通讯作者：
Clark DE
中科院分区：
文献类型：
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作者：
Peura C;Kilch JA;Clark DE
在农村地区，以人口为基础的机动车撞车死亡率一直较高，但尚不清楚这种差异在多大程度上可能是由于地理障碍或紧急医疗服务(EMS)的不足。我们试图分别分析与严重损伤发生相关的因素和与损伤发生后死亡相关的因素。通过国家公路交通安全管理局(NHTSA)的国家数据系统(SDS)获得了2005-2007年11个州警方报告的所有撞车事故的数据。Logistic回归用于估计与以下因素相关的因素：(1)死亡；(2)严重(丧失能力或致命性)损伤；(3)因严重损伤而死亡。模型包括与人、车辆和事件相关的协变量；县位置使用城乡连续体代码(RUCC)指定。年龄较大、不系腰带、弹射、酗酒、超速和清晨时间与严重受伤和死亡的风险增加相关。控制了这些因素，并限制了对遭受严重伤害的人的分析，调整后的优势比(AOR)与死亡相关的县分类为农村(RUC6-7，AOR 1.23，95%CI 1.16-1.31)或非常农村(RUC8-9，AOR 1.31，95%CI 1.18-1.46)。在车祸中严重受伤的人如果在农村地区死亡的可能性更大，这可能是由于EMS的限制。随着NHTSA-SDS数据变得更加可用和更加统一，它们可能有助于探索导致这种风险增加的特定因素。
The population-based rate of motor vehicle crash mortality is consistently higher in rural locations, but it is unclear how much of this disparity might be due to geographic barriers or deficiencies in emergency medical services (EMS). We sought to analyze separately factors associated with the occurrence of a severe injury and those associated with death after injury had occurred. Data from all police-reported crashes in 11 states from 2005–2007 were obtained through the National Highway Traffic Safety Administration (NHTSA) State Data System (SDS). Logistic regression was used to estimate factors associated with (1) death; (2) severe (incapacitating or fatal) injury; and (3) death given severe injury. Models included covariates related to the person, vehicle, and event; county location was specified using Rural–Urban Continuum Codes (RUCC). Older age, not wearing a belt, ejection, alcohol involvement, high speed, and early morning times were associated with increased risk of both severe injury and death. Controlling for these factors, and restricting analysis to persons who had suffered a severe injury, the adjusted odds ratio (aOR) associated with death was higher for counties classified rural (RUCC 6–7, aOR 1.23, 95% CI 1.16–1.31) or very rural (RUCC 8–9, aOR 1.31, 95% CI 1.18–1.46). Persons severely injured in crashes are more likely to die if they are in rural locations, possibly due to EMS constraints. As NHTSA-SDS data become more available and more uniform, they may be useful to explore specific factors contributing to this increased risk.