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Prediction of mortality risk in victims of violent crimes.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Anaesthesiology and Intensive Care. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics.
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2017 (English)In: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 281, 92-97 p., S0379-0738(17)30416-4Article in journal (Refereed) Epub ahead of print
Abstract [en]

BACKGROUND: To predict mortality risk in victims of violent crimes based on individual injury diagnoses and other information available in health care registries.

METHODS: Data from the Swedish hospital discharge registry and the cause of death registry were combined to identify 15,000 hospitalisations or prehospital deaths related to violent crimes. The ability of patient characteristics, injury type and severity, and cause of injury to predict death was modelled using conventional, Lasso, or Bayesian logistic regression in a development dataset and evaluated in a validation dataset.

RESULTS: Of 14,470 injury events severe enough to cause death or hospitalization 3.7% (556) died before hospital admission and 0.5% (71) during the hospital stay. The majority (76%) of hospital survivors had minor injury severity and most (67%) were discharged from hospital within 1day. A multivariable model with age, sex, the ICD-10 based injury severity score (ICISS), cause of injury, and major injury region provided predictions with very good discrimination (C-index=0.99) and calibration. Adding information on major injury interactions further improved model performance. Modeling individual injury diagnoses did not improve predictions over the combined ICISS score.

CONCLUSIONS: Mortality risk after violent crimes can be accurately estimated using administrative data. The use of Bayesian regression models provides meaningful risk assessment with more straightforward interpretation of uncertainty of the prediction, potentially also on the individual level. This can aid estimation of incidence trends over time and comparisons of outcome of violent crimes for injury surveillance and in forensic medicine.

Place, publisher, year, edition, pages
2017. Vol. 281, 92-97 p., S0379-0738(17)30416-4
Keyword [en]
Bayesian inference, Forensic medicine, Mortality, Violent crime
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-334432DOI: 10.1016/j.forsciint.2017.10.015PubMedID: 29125989OAI: oai:DiVA.org:uu-334432DiVA: diva2:1159607
Available from: 2017-11-23 Created: 2017-11-23 Last updated: 2017-11-23

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Gedeborg, RolfByberg, LiisaMichaëlsson, KarlThiblin, Ingemar
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Anaesthesiology and Intensive CareUCR-Uppsala Clinical Research CenterOrthopaedicsForensic Medicine
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