Estimating the number of seriously injured road users using the national hospital data, France, 2010-2019
Résumé
Introduction: Many countries use hospital discharge data to estimate the number of hospitalized road users, and among them those seriously injured. However, in France, the external cause of the ICD classification-which enables to distinguish road traffic injuries from sport or occupational injuries-is missing at 70%. Method: To overcome this issue, we use the inverse probability weighting method. First, we modelled among all hospitalized patients having a traumatic injury, the probability that the external cause was completed, using a logistic multinomial model. Covariates were either characteristics of the patients (duration of stay, age, nature of injury…) or characteristics of the hospital (public/private, …). Secondly, using the estimated inverse probabilities as weights, we obtained the estimated number of hospitalized patients following a road crash. Finally, using a mapping from AAAM between ICD 10 codes and MAIS 3+ (yes/no), we could estimate the number of seriously injured road users. Results: It is estimated that in France, about 100 000 road users are hospitalized each year, between 2010 and 2019, and among them, about 18 000 are seriously injured (MAIS3+), with an incidence of 28.3 per 100 000 inhabitants. There are about 2300 seriously injured pedestrians per year, 4000 cyclists, 5800 users of motorized two-wheel, 5500 car occupants and 200 occupants of vans or heavy vehicles. Conclusion: The estimated number of seriously injured road users is similar to the one estimated by another approach in France (capture-recapture on the Rhone road trauma registry and police data, followed by projection over France). Furthermore, it leads to a ratio of 5.3 MAIS3+/killed whereas it is around 3-4 in Belgium, Italy, Portugal, Spain and Sweden (Safetycube), but no country accounted for missing external cause (which is 17 % in two of these countries, and not provided in the other three).
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