412salud pública de méxico / vol. 58, no. 4, julio-agosto de 2016 Pérez-Núñez R y col. Subestimación de la mortalidad causada por el tránsito en México: análisis subnacionalRicardo Pérez-Núñez, D en CS, (1) Mariana G Mojarro-Íñiguez, MC Part, M en CS, (2) Ma. Eulalia Mendoza-García, L en Soc,Sergio Rodrigo Rosas-Osuna, MC Part, M en Admon Sist Salud, (1) Martha Híjar, D en C.((1) Secretariado Técnico del Consejo Nacional para la Prevención de Accidentes. México, Distrito Federal.(2) Investigadora independiente. Resumen Objetivo. Estimar la potencial subestimación de la mortalidad por lesiones de tránsito en las entidades federativas de México para un periodo de 15 años. Se buscó identificar variables sociales y económicas de cada entidad federativa que pudieran estar potencialmente asociadas con la calidad de la clasificación estadística de las defunciones. Material y métodos. Análisis secundario de bases de mortalidad, periodo 1999-2013. Mediante modelos de imputación múl-tiple, se identificaron los registros que pudieran ser muertes atribuidas al tránsito y se realizó un análisis de correlación simple. Resultados. La subestimación de defunciones por lesiones de tránsito durante el periodo fue de 18.85%, con importantes variaciones por entidad federativa. No hubo evidencia de que existiera asociación de alguna variable con el porcentaje de subestimación de la mortalidad. Conclusiones. La clasificación de la mortalidad es diferente en las entidades federativas. Esta información es de gran utilidad para focalizar intervenciones que permitan mejorar el registro de las defunciones en el país. AbstractObjective. To estimate the potential underestimation of mortality from traffic injuries at the subnational level in Mexico for a period of 15 years and to identify social and economic variables at the state level that could potentially be associated with the quality of statistical classification of deaths. Materials and methods. Secondary analysis of validated mortality databases for the period 1999-2013 was conducted. Using multiple imputation models, registries that could potentially be attributed to road traffic deaths were estimated and the potential underestimation of mortality due to this external cause was quantified. A simple correlation analysis was carried out. Results. The potential underestimation of deaths from traffic injuries during the period was 18.85% at the national level, with significant variations by state. From the data analyzed, there was no statistical evidence of any association of the percentage of road traffic deaths underestimation with the variables analyzed. Conclusions. Performance in terms of mortality classification is different at the state level in Mexico. This information is useful for targeting interventions to improve the recording of deaths in the country.

No abstract

Para analizar las lesiones fatales y no fatales de tránsito ocurridas en ciclistas, y documentar el uso de casco buscando informar las políticas públicas de transporte sostenible, se realizó un análisis descriptivo de cuatro fuentes de información secundaria a escala nacional: mortalidad, egresos

BackgroundRecently, different Mexican cities have implemented public policies on sustainable mobility, including the promotion of bicycle as means of transport. It is not evident to what extend policies include measures to promote road safety and thus we expect road traffic injuries (RTI) will increase in this road user. To inform these policies, we analysed RTI amongst cyclist as well as helmet use.MethodsAnalysis of 4 secondary databases: preliminary mortality figures, Ministry of Health hospital discharges (50% of all hospital discharges in the country), ER and hospital statistical registries (SIS-17), and the 2012 National Health and Nutrition Survey (ENSANUT), representative at the national level. Only ENSANUT and SIS-17 report helmet use. Except for ENSANUT information analysed is of 2014, the latest information available.ResultsDeaths: 138 (1% of all RTI); 97% male, 65% died on the scene, mean age = 46. Most severe injuries were in the head (68%), thorax (11%) and multiple regions (9%). Hospitalizations: 392 (1% of RTI), 83% male, mean age = 33. Main injury was in the head (32%), leg (17%) and multiple regions (12%). SIS-17: 667 cyclists were recorded, 80% male, mean age = 30. Helmet use was not recorded in 71%, when specified 2.6% reported its use. Most severe injury was multiple regions (29%), head (21%), and leg (10%). ENSANUT: estimated 165,348 cyclists not-fatally injured, 87% male, mean age = 25, SE = 3.6, 9.8% used helmet. Region most affected was leg (38%), arm (35%) and head (23%). Although no helmeted cyclists reported head injuries vs 24% amongst non-helmeted, difference was not statistically significant.ConclusionsHead injuries are common among cyclists and helmet use is low. Whereas cyclist-friendly infrastructure is an effective intervention to prevent injuries in the long term, helmet use could potentially reduce the frequency and severity of head injuries in the short run while bicycle widespread as a means of transport provides “safety in numbers”.

BackgroundQuality of data is essential to best understand the real magnitude and consequences of road traffic injuries (RTI). The objective of this study was to estimate the potential underestimation of RTI mortality at the subnational level in Mexico for a period of 15 years and to identify social and economic variables at the state level potentially associated with the quality of statistical classification of deaths.MethodsWe conducted secondary analysis of validated mortality databases for the period 1999–2013. Five categories of relevant “garbage codes” pertinent for RTI were identified and the percentage they represent of the total was estimated. Using multiple imputation models, registries statistically likely to be due to RTI were estimated and the potential underestimation of mortality was quantified. We explore correlation between health resource availability, social and economic variables with the percentage of underestimation of mortality caused by RTI at the state level using the Kendall’s rank correlation test.Results1.99% of all deaths were assigned to “R” codes; 2.40% were injuries of undetermined intent; in 22.96% of unintentional injuries the external cause is not codified; and 0.11% of transport injuries did not specify the means of transport. In over 40% of RTI, the specific road user deceased was unknown. The potential underestimation of deaths from RTI during the period was 18.85% at the national level, with significant variations amongst the 32 Mexican states, varying from 5.32% in Queretaro to 51.49% in Baja California. From the data analysed, there was no statistical evidence of any association of the percentage of RT deaths underestimation with variables analysed.ConclusionsPerformance in terms of mortality classification is different at the state level, but more analysis is needed to better understand underlying reasons of garbage coding. This information is useful for targeting interventions to improve recording of deaths in Mexico.