Enhancing trauma registries by integrating traffic records and geospatial analysis to improve bicyclist safety

Abstract

BACKGROUND:Trauma registries are used to identify modifiable injury risk factors for trauma prevention efforts. However, these may miss factors useful for prevention of bicycle-automobile collisions, such as vehicle speeds, driver intoxication, street conditions, and neighborhood characteristics. We hypothesize that (GIS) analysis of trauma registry data matched with a traffic accident database could identify risk factors for bicycle-automobile injuries and better inform injury prevention efforts. METHODS:The trauma registry of a US Level I trauma center was used retrospectively to identify bicycle-motor vehicle collision admissions from January 1, 2010, to December 31, 2018. Data collected included demographics, vitals, injury severity scores, toxicology, helmet use, and mortality.Matching with the Statewide Integrated Traffic Records System was done to provide collision, victim and GIS information. The GIS mapping of collisions was done with census tract data including poverty level scoring. Incident hot spot analysis to identify statistically significant incident clusters was done using the Getis Ord Gi* statistic. RESULTS:Of 25,535 registry admissions, 531 (2.1%) were bicyclists struck by automobiles, 425 (80.0%) were matched to Statewide Integrated Traffic Records System. Younger age (odds ratio [OR], 1.026; 95% confidence interval [CI], 1.013-1.040, p < 0.001), higher census tract poverty level percentage (OR, 0.976; 95% CI, 0.959-0.993, p = 0.007), and high school or less education (OR, 0.60; 95 CI, 0.381-0.968; p = 0.036) were predictive of not wearing a helmet. Higher census tract poverty level percentage (OR, 1.019; 95% CI, 1.004-1.034; p = 0.012) but not educational level was predictive of toxicology positive-bicyclists in automobile collisions. Geographic information systems analysis identified hot spots in the catchment area for toxicology-positive bicyclists and lack of helmet use. CONCLUSION:Combining trauma registry data and matched traffic accident records data with GIS analysis identifies additional risk factors for bicyclist injury. Trauma centers should champion efforts to prospectively link public traffic accident data to their trauma registries.

Integrating traffic safety data with area deprivation index: A method to better understand the causes of pediatric pedestrian versus automobile collisions

“…The SWITRS is a law enforcement report administered by the California Highway Patrol. This system includes a law enforcement report of all injury traffic collisions in the State of California, and it comprises more than 122 data fields per case 10 . Record matching was performed by correlating demographic data from SWITRS with collision date-matched information from our institutional trauma registry.…”

“…This system includes a law enforcement report of all injury traffic collisions in the State of California, and it comprises more than 122 data fields per case. 10 Record matching was performed by correlating demographic data from SWITRS with collision date-matched information from our institutional trauma registry. To assess traffic safety, Google Earth Pro was used to collect sidewalk coverage data and the proximity of the collision to the patient's home address.…”

Youth violence prevention can be enhanced by geospatial analysis of trauma registry data

“…Hospital-based violence intervention program surveillance for youth violence prevention can be performed via trauma registry and police records databases to understand the target population. Geographic information systems (GIS) have been used to understand relationships between trauma mechanisms, locations, and social determinants for injury prevention 5–11 . The GIS systems can provide additional community characteristics for crime and social determinants down to individual census tracts.…”

“…Geographic information systems (GIS) have been used to understand relationships between trauma mechanisms, locations, and social determinants for injury prevention. [5][6][7][8][9][10][11] The GIS systems can provide additional community characteristics for crime and social determinants down to individual census tracts. Geographic information system can also identify "hotpots" and clusters of recurrent violence.…”