Predictors and burden of injury mortality in the Thai cohort study 2005–2015

Background: Thailand is a high injury burden setting. In 2015 it had the world’s second highest rate of road traffic fatalities. In order to develop strategies to reduce this burden an accurate understanding of the development of injury risk over the life course is essential. Methods: A national cohort of adult Thais was recruited in 2005 (n = 87,151). Participants completed a health questionnaire covering geodemographic, behavioural, health and injury data. Citizen ID numbers were matched with death registration records, identifying deaths from any injury. Adjusted logistic regression models were used to measure associations between baseline exposures and injury deaths between 2005 and 2015. Results: Injury mortality comprised 363 individuals, the majority (36%) from traffic injuries. Predictors of all-injury mortality were being male (AOR 3.55, 95% CI 2.57–4.89), Southern Thai (AOR 1.52, 95% CI 1.07–2.16), smoking (AOR 1.55, 95% CI 1.16–2.17), depression (AOR 1.78, 95% CI 1.07–2.96), previous injury (AOR 1.37, 95% CI 1.03–1.81) and drink driving history (AOR 1.37, 95%CI 1.02–1.85). Age and region of residence were stronger predictors for men, while anxiety/depression was a stronger predictor for women. Among males in the far south, assault caused the largest proportion of injury mortality, elsewhere traffic injury was most common. Conclusions: This study identifies that a history of drink driving, but not regular alcohol consumption, increased injury risk. The associations between smoking and depression, and injury mortality also need further consideration.