Home injuries mortality: Sensitivity and specificity analysis of different data sources and operative definitions

The aim of this longitudinal study was to test different operational definitions of home accident mortality. Methods: The sources of data were the Emergency Information System, hospital discharge reports and the mortality registry of the Lazio Region, 2000-2001. We selected all emergency room visits for unintentional traumas that occurred at home. A 9-month follow-up was performed to calculate mortality rates. A sensitivity analysis of in-hospital mortality, deaths within 30 days and deaths from home accident E-codes was performed. A gold standard definition of home accident-related deaths was proposed. Results: We observed 598 home accident-related fatalities (29.1% of all the deaths found in the follow-up study). In-hospital mortality, deaths within 30 days and deaths for home accident E-codes had sensitivity values of 63.4%, 63.4% and 59.4%, respectively; positive predictive values were 78.1%, 67.1% and 100%, respectively. Conclusions: The best operational definition of home injury was based on in-hospital mortality, while mortality based on E-codes reported on death certificates was lacking. In order to measure the real burden of home injuries, hospital and mortality data must be integrated.