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Safety 2012 World Conference October 3, 2012

Concordance of Identified Drugs in Injured Motor Vehicle Drivers Using Linked Crash , Emergency Department, and Inpatient Hospitalization Datasets . Safety 2012 World Conference October 3, 2012 Terry Bunn, PhD, Michael Singleton, MS, Svetla Slavova, PhD, Valerie N icholson, MD. Drug Use.

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Safety 2012 World Conference October 3, 2012

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  1. Concordance of Identified Drugs in Injured Motor Vehicle Drivers Using Linked Crash, Emergency Department, and Inpatient Hospitalization Datasets Safety 2012 World Conference October 3, 2012 Terry Bunn, PhD, Michael Singleton, MS, Svetla Slavova, PhD, Valerie Nicholson, MD

  2. Drug Use • Strong predictor of motor vehicle crashes • Culpability in crashes • Risk factor for greater injury severity in nonfatal collisions • Half of the drivers admitted to a Level-1 trauma center over a 90-day period tested positive for drugs

  3. Study Purpose • Linkage of data sets to assess the concordance in the identification of nondependent drug abuse among injured motor vehicle drivers in Kentucky.

  4. Study Data • CRASH reports for years 2000-2010 • Inpatient hospitalization records for years 2000- 2010 • Emergency department records for years 2008- 2010

  5. Number of Injured Kentucky Motor Vehicle Drivers Identified with the Presence of Drugs Using Hospitalization and CRASH Data by Year 1Linked inpatient hospitalization and CRASH records for years 2000-2010.

  6. Trend Curves of Percentages of Drugged Drivers

  7. Drugged Motor Vehicle Drivers by Age and Gender 1, 2 1 Emergency department records available for years 2008-2010 2 Inpatient hospitalization records available for years 2000-2010

  8. Vehicle Types Involved in Motor Vehicle Collisions with Drugged Drivers, 2000-2010.1, 2, 3 1 ICD-9-CM diagnosis code 305 = “nondependent abuse of drugs” 2 Emergency department records available for years 2008-2010 3 Inpatient hospitalization records available for years 2000-2010

  9. Identification of Drugged Motor Vehicle Drivers Using Linked Emergency Department, Inpatient Hospitalization, and CRASH datasets in Kentucky, 2008-2010. 1 ICD-9-CM diagnosis code 305 = “nondependent abuse of drugs” 2 Human factor code 05 = “drug involvement”

  10. Number of Drug Types Present in Drugged Motor Vehicle Drivers Treated in the Emergency Department or Hospitalized in Kentucky.1, 2 1 Linked Emergency department-CRASH records available for years 2008-2010 2 Linked Inpatient hospitalization-CRASH records available for years 2000-2010 *Total number and number positive were suppressed since number positive was less than 5.

  11. Differences in Proportions of All Linked Emergency Department-CRASH and Inpatient Hospitalization- CRASH Records Diagnosed With Nondependent Abuse of Drugs With a Specific Substance Identified* * Conditional logistic regression; separate model for each substance and patient group; opioid as referent in all cases

  12. Types of Drug Testing Recorded in CRASH Reports of Injured Motor Vehicle Drivers Diagnosed with Nondependent Abuse of Drugs.1, 2 1 Linked CRASH-Emergency department records available for years 2008-2010 2 Linked CRASH-Inpatient hospitalization records available for years 2000-2010

  13. Conclusions • Surveillance data from multiple public health data sets is necessary to identify the presence of drugs in injured motor vehicle drivers • The incidence and prevalence of drugged driving may be underestimated when only one data source is utilized to identify the presence of drugs in injured motor vehicle drivers.

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