Comparative analysis of injury identification using KABCO and ISS in linked North Carolina trauma registry and crash data

Abstract

Objective

The purpose of this study was to examine differences between police-reported injury severity and trauma registry data among persons with linked records in North Carolina and quantify the degree of alignment.

Methods

We analyzed linked North Carolina trauma registry and motor vehicle crash data from 2018. Injury severity identification was assessed using police-reported 5-point scale KABCO from crash data and Injury Severity Score (ISS) from trauma records. The analysis was stratified by age, sex/gender, race, ethnicity, and road users type to examine differences across groups. We calculated sensitivity, specificity, positive predictive values, and negative predictive values between police-reported injury severity and trauma registry data using ISS as the gold standard.

Results

A higher proportion of patients were classified as suspected minor injuries (39.0%) compared to moderate injuries in trauma registry (25.1%). Police-reported crash data underreported injury severity when compared to trauma registry data. Police-reported KABCO had a higher degree of specificity when classifying minor injuries (79.3%) but substantially underestimated seriously injured patients, with a sensitivity of 49.9%. These findings were also consistent when stratified by subpopulations.

Conclusion

Hospital-based motor vehicle crash data are a main source of injury severity identification for road safety. Police-reported data were relatively accurate for minor injuries but not seriously injured patients. Understanding the characteristics of each data source both separately and linked will be critical for problem identification and program development to move toward a safe transportation system for all road users.

Keywords:

• Motor vehicle crashes
• linked data
• injuries
• police-reported crash data

Acknowledgments

The authors gratefully acknowledge the efforts of the North Carolina Office of Emergency Medical Services, the North Carolina Trauma Registry hospitals, Anna Waller, ScD and CCHI, as well as Laura Sandt, PhD, and the University of North Carolina Collaborative Science Center for Road Safety.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This project was supported by the Collaborative Sciences Center for Road Safety (www.roadsafety.unc.edu), a U.S. Department of Transportation National University Transportation Center promoting safety under USDOT Grant No. 69A3551747113.