Cohort Definition Name: “Motor Vehicle Accidents (MVA)”
Contributor name: Jill Hardin
Contributor OrcId: 0000-0003-2682-2187
Logic Description: All events of motor vehicle accidents with an emergency room or inpatient visit on index.
Recommended study application: outcome
Assertion statement: This cohort definition was executed on at least one real person-level observational health data source and resulted in a cohort with at least 1 person.
Submitted cohort definition:
Motor Vehicle Accidents.txt (5.8 KB)
Target Clinical Description
Overview:
Motor Vehicle accident
Overview: A motor vehicle accident, or crash, is an event in which a motor vehicle collides with another motor vehicle, pedestrian, animal or object. Motor vehicle accidents are a leading cause of death in children. Almost 41,000 people died in motor vehicle crashes in 2020; 600 of these deaths occurred in children ages 12 years old and younger [1]. Motor vehicle accidents may be traffic-related, including those injured or killed while on the roadway and non-traffic related, involving those struck on driveways or private lots, an important subset of the injured among younger children [2]. In the US, 16% of children killed in motor vehicle accidents are pedestrians [3].
Synonyms: Motor vehicle crash, traffic accident
Presentation: Patients who are involved in motor vehicle accidents may present with a range of iynjuries, from mild to severe. Injuries may include musculoskeletal sprain and spasm, bruising, head and spinal trauma or hemorrhage, bony fractures, and abdominal trauma (with injury to spleen, liver, kidneys, or intestine).
Assessment: Assessment varies, but typically includes stabilization of the airway, breathing and circulation, followed by assessment of the Glasgow Coma Scale to describe the extent of impaired consciousness (if appropriate). Exam findings and details about the accident will determine if further testing is needed, typically radiographs and CT scans to evaluate for fractures or injuries to internal organs.
Plan: Plan will vary depending upon the injury.
- www.cdc.gov/transportationsafety
- Zonfrillo MR, Ramsay ML, Fennell JE, Andreasen A. Unintentional non-traffic injury and fatal events: threats to children in and around vehicles. Traffic Inj Prev 2018; 19(2):184-188.
- National Center for Statistics and Analysis (2022, November, revised). Children: 2020 data. (Traffic Safety Facts. Report No. DOT HS 813 2850. National Highway Traffic Safety Administration.
Phevaluator & results overview:
Phevaluator results show the highest PPV results for the phenotype that requires a second MVA code within 180 days of the first MVA code. This definition decreases the sensitivity compared to the phenotype that requires only 1 MVA code and has the highest sensitivity. The algorithm which requires 1 code for MVA and an emergency room or inpatient visit on index has a slightly lower sensitivity and PPV compared to the definition requiring only 1 MVA code. The numbers of subjects identified in the algorithm requiring the MVA code and an emergency room or inpatient visit are reduced by ~30% compared the one MVA code definition.
We recommend use of cohort that requires a single MVA code and ER or IP visit on index. The definition shows similar trends in time reported for motor accidents in the US. However, some of the observed increase in incidence post 2015 may be attributed to changes in icd9 to 10 codes. The group level characteristics around index is consistent with expected with high prevalence of injury, pain codes along with presence of diagnostic work ups (such as CT-scan and other imaging) and pian killers (such as acetaminophen and others) on index. There is unlikely to be an index event misclassification, given that over 90% of patients had an ER visit on index. It is hard to estimate the sensitivity of the definition, given that phevaluator results are subject to the limitation of the prediction model mentioned above.