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Fatality Analysis Reporting System demonstrates association between trauma system initiatives and decreasing death
C G Cayten1, I Quervalu, N Agarwal
1Our Lady of Mercy Medical Center, New York Medical College, Bronx 10455-2697, USA.
The Journal of Trauma
|May 25, 1999
Summary
Trauma system initiatives in New York, including regional efforts, were associated with significant decreases in motor vehicle crash deaths. These improvements show face validity despite limitations in FARS data for direct causation.
Area of Science:
- Public Health
- Trauma System Evaluation
- Injury Prevention
Background:
- Trauma registries often exclude out-of-hospital deaths, necessitating complementary monitoring methods.
- Assessing the impact of trauma system initiatives requires data beyond traditional trauma center registries.
- The study addresses the need to evaluate trauma system effectiveness using alternative data sources.
Purpose of the Study:
- To evaluate the impact of state and regional trauma system initiatives on motor vehicle crash mortality in the Hudson Valley, New York region over a 10-year period.
- To assess the face validity of using the Fatality Analysis Reporting System (FARS) and New York State Department of Motor Vehicles data for monitoring trauma system impact.
- To analyze trends in motor vehicle crash deaths in relation to specific trauma system developments.
Main Methods:
- Utilized Fatality Analysis Reporting System (FARS) and New York State Department of Motor Vehicles data from 1987-1996.
- Analyzed statewide initiatives (e.g., TC standards, triage protocols) and regional initiatives (e.g., helicopter services, additional TCs).
- Compared death rates in the Hudson Valley region and Westchester County to national trends and assessed patient transfer percentages to trauma centers.
Main Results:
- Motor vehicle crash death rates significantly decreased in the Hudson Valley (44%) and Westchester County (44%) from 1987-1996, exceeding the national decrease (16%).
- The proportion of seriously injured trauma patients transported to trauma centers increased from 53% to 72% during the study period.
- The New York State Trauma Advisory Committee acknowledged the data reflected the effects of implemented trauma system initiatives.
Conclusions:
- Decreases in motor vehicle crash death rates are likely influenced by both injury prevention and trauma system initiatives.
- While FARS and DMV data cannot establish definitive cause-and-effect, they effectively monitor the aggregated impact of multiple trauma system interventions.
- The observed association between decreasing mortality, increased trauma center utilization, and trauma system implementation demonstrates face validity.