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Complete Health Indicator Report of Traumatic Brain Injury (TBI)

Definition

TBI Hospitalizations Rate: The rate of TBIs of all injury intentions resulting in non-fatal hospitalizations per 10,000 population. For all definitions, these cases may include a TBI alone or in combination with other injuries or conditions. ICD-10-CM Hospital Codes for TBI Morbidity: S02.0, S02.1 Fracture of skull; S02.8, S02.91 Fracture of other specified skull and facial bones, unspecified fracture; S04.02, S04.03, S04.04 Injury of optic tract and pathways, injuries of visual cortex; S06 Intracranial injury; S07.1 Crushing injury of skull; T74.4 Shaken infant syndrome.

Numerator

TBI Hospitalization Rate: The number of TBIs of all injury intentions resulting in hospitalization which meet the case definition mentioned in the data notes explaining ICD-10-CM codes. TBI Hospitalizations and Deaths Percentage: The number of TBIs with a cause or set of causes as defined through medical record review, as part of the TBI Injury Surveillance Database sample.

Denominator

TBI Hospitalization Rate: The total number of persons in the population of Utah.

Data Interpretation Issues

Due to the transition to the ICD-10-CM coding system, data is available beginning in 2016. 2015 data is available from sampled traumatic brain injury (TBI) hospitalization and death cases, provided by the Violence and Injury Prevention Program, Traumatic Brain Injury Surveillance Program; this data was used to report etiology. TBI is defined as an occurrence of injury or death resulting from trauma to the head. With regard to injury, the occurrence must be documented in a medical record with one or more of the following: observed or self-reported loss of consciousness or decreased level of consciousness; amnesia; skull fracture; changes in motor function, sensory function, reflexes, or speech; seizures; or hemorrhages, bruising, or other trauma of the brain. With death, the injury has been listed on the death certificate, autopsy report, or medical examiner's report as a sequence that caused death. Clinical definitions of TBI exclude several conditions including: lacerations or contusions of the face, eye, or scalp without other criteria; fractures of facial bones without other criteria; birth trauma; primary anoxic, inflammatory, toxic, or metabolic encephalopathies which are not complications of head trauma; brain infarction (ischemic stoke); intracranial hemorrhage (hemorrhagic stroke) without associated trauma; airway obstruction (e.g., near-drowning, throat swelling, choking, strangulation, or crush injuries of the chest); seizure disorders (grand mal, etc.); intracranial surgery; and neoplasms.

Why Is This Important?

Traumatic brain injury is a leading cause of death and disability in Utah, costing more than $179 million in hospitalization charges in 2021. During 2021, the age-adjusted rate of Utahns hospitalized due to a TBI was 7.5 per 10,000. Based on sampled 2016-2017 TBI cases, more than half (52.8%) of TBI hospitalizations and deaths are the result of a fall. Motor vehicle traffic crashes (13.4%) are the second leading cause of TBI hospitalizations and deaths in Utah.

Other Objectives

{{style color:#1AA1B7 Healthy People 2030 Objective IVP-05:}}[[br]] Reduce fatal traumatic brain injuries[[br]] '''U.S. Target:''' 16.9 deaths per 100,000 population As compared to Healthy People 2020, Healthy People 2030 no longer provides specific objectives for nonfatal TBI rate reduction. Regardless, nonfatal TBI rates will still be monitored.

How Are We Doing?

The age-adjusted death rate of TBI in Utah in 2022 was 22.2 per 100,000 population. This rate was the same as the previous year's rate. From 2018 to 2022, age-adjusted rates of TBI for both sexes have not changed significantly. In 2022, rates of TBI deaths were greater for males compared to females (35.0 to 10.1). The age-adjusted hospitalization rate of TBI in Utah in 2021 was 7.54 per 10,000 population. This rate was higher than the previous year's rate of 7.4 per 10,000 population, but not significantly so. From 2018 to 2021, age-adjusted rates of TBI for both sexes have not changed significantly. In 2021, rates of TBI hospitalizations were greater for males compared to females (9.6 to 5.5).

How Do We Compare With the U.S.?

The most recent US age-adjusted death rate of TBI available is for 2021. Using 2021 values for both Utah and the US, the Utah age-adjusted death rate of TBI is greater than that of the US (22.2 to 19.5). The Utah age-adjusted death rate of TBI also exceeds the Healthy People 2030 Objective IVP-05 target of 16.9 deaths per 100,000 population. The US age-adjusted hospitalization rate of TBI was not available for 2021, so comparisons could not be made.

What Is Being Done?

The Utah Department of Health and Human Services, Violence and Injury Prevention Program (VIPP) receives funding from the U.S. Centers for Disease Control and Prevention to conduct TBI surveillance for the state of Utah. This is done through review of hospital discharge data, vital statistics data, and hospital records abstractions. These data are used to develop interventions and policies targeting those at highest risk (such as young people for motor vehicle incidents and the elderly for fall incidents). In 2018 VIPP was awarded a grant from the U.S. Department of Health & Human Services (HHS) Administration of Community Living (ACL). The purpose of the three year grant is to create and strengthen a system of services and supports that maximizes the independence, well-being, and health of persons with TBI across the lifespan, their families, and their caregivers by: 1) supporting and maintaining the Utah Brain Injury Council (TBI Advisory Board), 2) creating a TBI State Registry, 3) enhancing the TBI workforce through professional training, 4) providing information about TBI to families and referrals to appropriate services, and 5) improving local and national coordination and collaboration around TBI services and supports. With a previous grant, TBI was added to the Medical Home Portal to provide additional information about TBI diagnosis and treatment of young children (birth through age 4) for physicians, health care professionals, educators, families, and patients ([https://www.medicalhomeportal.org/]). The Traumatic Brain Injury (TBI) Fund was established in 2008 by the Utah Legislature as a restricted special revenue fund. The fund consists of gifts, grants, donations, and any other funding from private sources. Individuals with a TBI may receive help with resource facilitation or neuropsychological testing through the TBI Fund. The TBI Fund is designed to be a payor of last resort, meaning individuals have no other financial means available to obtain these services. More information on the TBI Fund can be found at [https://vipp.utah.gov/traumatic-brain-injury/]. The Traumatic Spinal Cord and Brain Injury Rehabilitation Fund was established during the 2012 Utah Legislative Session (Section 26-54) as a restricted special revenue fund that consists of gifts, grants, donations, or any other conveyance of money that may be made to the fund from private sources; portion ($20) of the impound fee as designated in Section 41-6a-1406; and amounts as appropriated by the legislature. The Legislature appropriated an initial allocation of $200,000 for State Fiscal Year 2013. The SCI/TBI Rehabilitation Fund provides individuals with spinal cord or traumatic brain injuries with physical, occupational, and speech therapy; and equipment necessary for daily living activities. More information on the SCI/TBI Rehabilitation Fund can be found at [https://vipp.utah.gov/traumatic-brain-injury/].

Available Services

Established by the Utah State Legislature in 2008, the TBI Fund seeks to educate and empower those whose lives have been impacted by the effects of a traumatic brain injury. Individuals with a TBI may receive help with resource facilitation or neuropsychological testing through the TBI Fund. Resource facilitation is a process that involves working with caring, trained experts who understand what someone with a TBI is going through. These experts provide short-term support to help the person with the TBI and their family members meet their goals and successfully return to school, work, or other daily activities. The TBI Fund is a payor of last resort, meaning individuals have no other financial means available to obtain these services. However, everyone who calls the Utah TBI Fund for help receives a free intake assessment and consultation from a trained brain injury coach. Individuals may also qualify to receive help with physical, occupational, and speech therapy or equipment needed for daily living through the Utah Traumatic Spinal Cord and Brain Injury Rehabilitation Fund. Additional information can be found at [https://vipp.utah.gov/traumatic-brain-injury/].

Health Program Information

The Violence and Injury Prevention Program (VIPP) is a trusted and comprehensive resource for data related to violence and injury. Through education, this information helps promote partnerships and programs to prevent injuries and improve public health. The VIPP goals are to a) focus prevention efforts on reducing intentional and unintentional injury, b) conduct education aimed at increasing awareness and changing behaviors that contribute to the occurrence of injury, c) strengthen local health department capacity to conduct local injury prevention programs, d) promote legislation, policy changes, and enforcement that will reduce injury hazards and increase safe behaviors, e) collaborate with private and public partners, and f) improve the Utah Department of Health and Human Services capacity to collect mortality and morbidity data from multiple sources and conduct injury epidemiology for use in prevention planning, implementation, and evaluation.


Related Indicators

Related Relevant Population Characteristics Indicators:


Risk Factors

TBIs are most commonly caused by a fall, firearm-related injury, motor vehicle crash, or an assault. Falls are responsible for nearly half of TBI-related hospitalizations. Firearm-related suicide is the most common cause of TBI-related deaths in the United States. TBIs affect the lives of people of all ages. Anyone can experience a TBI, but data suggest that some groups are at greater risk of dying from a TBI or experiencing long-term health problems after the injury. Examples of groups who are more likely to be affected by TBI, include: older adults, racial and ethnic minorities, service members and veterans, people who experience homelessness, people who are in correctional and detention facilities, survivors of intimate partner violence, and people living in rural areas.

Related Risk Factors Indicators:




Graphical Data Views

TBI hospitalization age-adjusted rates by sex, Utah, 2016-2021

::chart - missing::
confidence limits

Between 2016 and 2021, TBI hospitalization rates have remained fairly consistent. Male age-adjusted rates are higher than female age-adjusted rates for all years.
UT M, UT F, US M, US FYearAge-adjusted Rate per 10,000 PopulationLower LimitUpper Limit
Record Count: 12
Utah Males20169.69.010.1
Utah Males20179.59.010.0
Utah Males20189.69.110.2
Utah Males20199.69.110.1
Utah Males20209.59.010.0
Utah Males20219.69.110.1
Utah Females20165.95.56.3
Utah Females20176.25.76.6
Utah Females20185.65.26.0
Utah Females20196.05.66.4
Utah Females20205.45.15.8
Utah Females20215.55.25.9

Data Notes

ICD-10-CM codes for TBI Morbidity: S02.0, S02.1, S02.8, S02.91, S04.02, S04.03, S04.04, S06, S07.1, T74.4; ICD-10 codes for TBI Mortality: S01.0-S01.9, S02.0, S02.1, S02.3, S02.7-S02.9, S04.0, S06.0-S06.9, S07.0, S07.1, S07.8, S07.9, S09.7-S09.9, T01.0, T02.0, T04.0, T06.0, T90.1, T90.2, T90.4, T90.5, T90.8, T90.0. These cases may include a TBI alone or in combination with other injuries or conditions.   [[br]] [[br]] Rates have been age-adjusted to the 2000 U.S. population.

Data Sources

  • Utah Inpatient Hospital Discharge Data, Healthcare Information & Analysis Programs, Office of Research & Evaluation, Utah Department of Health and Human Services
  • Population Estimates for 2000-2019: National Center for Health Statistics (NCHS) through a collaborative agreement with the U.S. Census Bureau, IBIS Version 2020
  • For years 2020 and later, the population estimates are provided by the Kem C. Gardner Policy Institute, Utah state and county annual population estimates are by single year of age and sex, IBIS Version 2022


TBI hospitalization rates by age group and sex, Utah, 2018-2021

::chart - missing::
confidence limits

Males have significantly higher rates of TBI-related hospitalizations compared to females in almost all age groups. Rates of TBI-related hospitalizations per 10,000 population were highest among older adults aged 75+.
Males vs. FemalesAge GroupRate per 10,000 PopulationLower LimitUpper Limit
Record Count: 26
MaleLess than 1 year14.812.417.4
Male1-4 years4.03.44.6
Male5-9 years3.73.24.2
Male10-14 years4.43.95.0
Male15-17 years8.37.49.4
Male18-19 years8.26.99.6
Male20-24 years6.86.17.5
Male25-34 years6.25.76.7
Male35-44 years6.05.56.5
Male45-54 years7.77.08.4
Male55-64 years10.49.611.3
Male65-74 years16.215.017.4
Male75+ years44.341.847.0
FemaleLess than 1 year12.09.914.5
Female1-4 years3.42.94.1
Female5-9 years2.11.72.5
Female10-14 years2.42.02.8
Female15-17 years4.23.55.0
Female18-19 years3.22.54.1
Female20-24 years2.11.72.6
Female25-34 years1.91.72.2
Female35-44 years2.42.12.8
Female45-54 years3.32.93.8
Female55-64 years5.85.26.5
Female65-74 years11.410.512.4
Female75+ years36.534.538.6

Data Notes

ICD-10-CM codes for TBI Morbidity: S02.0, S02.1, S02.8, S02.91, S04.02, S04.03, S04.04, S06, S07.1, T74.4; ICD-10 codes for TBI Mortality: S01.0-S01.9, S02.0, S02.1, S02.3, S02.7-S02.9, S04.0, S06.0-S06.9, S07.0, S07.1, S07.8, S07.9, S09.7-S09.9, T01.0, T02.0, T04.0, T06.0, T90.1, T90.2, T90.4, T90.5, T90.8, T90.0. These cases may include a TBI alone or in combination with other injuries or conditions.   [[br]] [[br]] Rates are calculated using TBI-related hospitalizations.

Data Sources

  • Utah Inpatient Hospital Discharge Data, Healthcare Information & Analysis Programs, Office of Research & Evaluation, Utah Department of Health and Human Services
  • Population Estimates for 2000-2019: National Center for Health Statistics (NCHS) through a collaborative agreement with the U.S. Census Bureau, IBIS Version 2020
  • For years 2020 and later, the population estimates are provided by the Kem C. Gardner Policy Institute, Utah state and county annual population estimates are by single year of age and sex, IBIS Version 2022


TBI hospitalization rates by local health district, Utah, 2016-2021

::chart - missing::
confidence limits

Local Health DistrictAge-adjusted Rate per 10,000 PopulationLower LimitUpper Limit
Record Count: 14
Bear River5.785.326.28
Central8.898.079.77
Davis County6.255.896.63
Salt Lake County8.948.79.18
San Juan3.072.014.5
Southeast6.395.427.48
Southwest6.936.527.35
Summit9.998.711.43
Tooele7.786.898.76
TriCounty7.946.978.99
Utah County7.296.977.63
Wasatch8.276.979.75
Weber-Morgan7.076.657.5
State of Utah7.647.497.79

Data Notes

ICD-10-CM codes for TBI Morbidity: S02.0, S02.1, S02.8, S02.91, S04.02, S04.03, S04.04, S06, S07.1, T74.4; ICD-10 codes for TBI Mortality: S01.0-S01.9, S02.0, S02.1, S02.3, S02.7-S02.9, S04.0, S06.0-S06.9, S07.0, S07.1, S07.8, S07.9, S09.7-S09.9, T01.0, T02.0, T04.0, T06.0, T90.1, T90.2, T90.4, T90.5, T90.8, T90.0. These cases may include a TBI alone or in combination with other injuries or conditions.   Rates are calculated using TBI-related hospitalizations.

Data Sources

  • Utah Inpatient Hospital Discharge Data, Healthcare Information & Analysis Programs, Office of Research & Evaluation, Utah Department of Health and Human Services
  • Population Estimates for 2000-2019: National Center for Health Statistics (NCHS) through a collaborative agreement with the U.S. Census Bureau, IBIS Version 2020
  • For years 2020 and later, the population estimates are provided by the Kem C. Gardner Policy Institute, Utah state and county annual population estimates are by single year of age and sex, IBIS Version 2022


TBI hospitalization age-adjusted rates by Utah small area, 2016-2021

::chart - missing::
confidence limits

From 2016-2021, the Utah age-adjusted rate of TBI hospitalizations was 7.01 per 10,000.
Utah Small AreasAge-adjusted Rate per 10,000 PopulationLower LimitUpper LimitNote
Record Count: 100
Brigham City4.63.65.8
Box Elder Co (Other) V26.95.09.2
Tremonton7.45.89.3
Logan V24.84.05.8
North Logan4.83.66.2
Cache (Other)/Rich (All) V25.74.57.2
Hyrum6.64.29.8
Smithfield6.04.38.1
Ben Lomond6.86.07.8
Weber County (East)6.05.07.1
Morgan County7.95.910.3
Ogden (Downtown)7.46.38.6
South Ogden5.74.86.8
Roy/Hooper5.54.66.5
Riverdale8.47.09.9
Clearfield Area/Hooper6.65.77.6
Layton/South Weber4.53.85.2
Kaysville/Fruit Heights4.94.06.1
Syracuse6.24.68.3
Centerville5.24.06.8
Farmington6.55.08.3
North Salt Lake8.66.710.9
Woods Cross/West Bountiful5.74.08.0
Bountiful6.55.77.4
SLC (Rose Park)8.06.89.4
SLC (Avenues)5.94.77.3
SLC (Foothill/East Bench)6.65.38.1
Magna7.96.49.6
SLC (Glendale) V29.37.611.3
West Valley (Center)8.77.610.0
West Valley (West) V28.16.310.2
West Valley (East) V28.77.69.9
SLC (Downtown) V214.412.716.2
SLC (Southeast Liberty)5.74.47.3
South Salt Lake9.47.811.1
SLC (Sugar House)7.96.79.1
Millcreek (South)7.46.19.0
Millcreek (East)6.65.48.0
Holladay V27.96.69.4
Cottonwood7.36.38.3
Kearns V29.88.311.5
Taylorsville (E)/Murray (W)7.46.38.7
Taylorsville (West)8.57.29.9
Murray8.17.09.4
Midvale8.26.99.6
West Jordan (Northeast) V27.66.29.2
West Jordan (Southeast)7.96.69.4
West Jordan (W)/Copperton5.84.37.5
South Jordan V26.35.37.4
Daybreak9.37.012.2
Sandy (West)8.67.310.2
Sandy (Center) V25.54.46.8
Sandy (Northeast)7.05.78.5
Sandy (Southeast)6.95.78.4
Draper9.48.011.0
Riverton/Bluffdale7.36.08.7
Herriman7.35.89.1
Tooele County (Other)7.55.99.6
Tooele Valley6.95.98.0
Eagle Mountain/Cedar Valley5.84.28.0
Lehi6.55.57.7
Saratoga Springs6.84.99.1
American Fork7.36.28.5
Alpine4.52.96.6
Pleasant Grove/Lindon7.26.28.4
Orem (North)7.86.59.3
Orem (West)7.05.88.4
Orem (East)5.84.67.2
Provo/BYU5.64.66.7
Provo (West City Center)7.56.19.2
Provo (East City Center)6.64.89.0
Salem City7.25.29.8
Spanish Fork8.87.410.3
Springville7.56.29.0
Mapleton7.55.410.2
Utah County (South) V28.26.010.8
Payson9.98.311.8
Park City9.98.211.9
Summit County (East)8.36.210.9
Wasatch County7.86.59.3
Daggett and Uintah County7.86.69.2
Duchesne County7.15.68.9
Nephi/Mona11.08.214.4
Delta/Fillmore7.15.29.4
Sanpete Valley8.77.110.6
Central (Other)9.78.211.6
Richfield/Monroe/Salina6.65.08.4
Carbon County6.35.07.8
Emery County8.26.010.8
Grand County4.12.66.2
Blanding/Monticello3.31.85.5
San Juan County (Other)2.31.04.4*
St. George7.26.68.0
Washington Co (Other) V28.66.411.3
Washington City6.04.87.3
Hurricane/La Verkin6.25.17.6
Ivins/Santa Clara6.44.98.1
Cedar City6.35.37.4
Southwest LHD (Other)6.85.68.2
State of Utah7.06.97.1

Data Notes

ICD-10-CM codes for TBI Morbidity: S02.0, S02.1, S02.8, S02.91, S04.02, S04.03, S04.04, S06, S07.1, T74.4; ICD-10 codes for TBI Mortality: S01.0-S01.9, S02.0, S02.1, S02.3, S02.7-S02.9, S04.0, S06.0-S06.9, S07.0, S07.1, S07.8, S07.9, S09.7-S09.9, T01.0, T02.0, T04.0, T06.0, T90.1, T90.2, T90.4, T90.5, T90.8, T90.0. These cases may include a TBI alone or in combination with other injuries or conditions.   [[br]][[br]]*Use caution in interpreting; the estimate has a coefficient of variation >30% and is therefore deemed unreliable by DHHS standards. Statistical significance is determined by whether a region's confidence bounds overlap with the state's rate. Rates age-adjusted to the 2000 U.S. standard population.

Data Sources

  • Utah Inpatient Hospital Discharge Data, Healthcare Information & Analysis Programs, Office of Research & Evaluation, Utah Department of Health and Human Services
  • Population estimates used linear interpolation of U.S. Census Bureau, Kem C. Gardner Policy Institute population estimates, and ESRI ZIP Code data provided annual population estimates for ZIP Code areas by sex and age groups, IBIS Version 2022


Percentage of TBI hospitalizations and deaths by etiology, Utah, 2016-2017

::chart - missing::
confidence limits

Of sampled TBI cases, more than half (52.8%) of TBI hospitalizations and deaths are the result of falls. Motor vehicle traffic crashes (13.4%) are the second leading cause of TBI hospitalizations and deaths in Utah.
EtiologyPercentage of CasesLower LimitUpper LimitNoteNumer- atorDenom- inator
Record Count: 15
Falls52.8%50.2%55.4%7441,409
Motor vehicle crashes13.4%11.6%15.2%1891,409
OHV/ATV5.3%4.1%6.4%741,409
Pedestrian3.5%2.6%4.5%501,409
Bicycle crashes5.3%4.2%6.5%751,409
Motorcycle crashes3.9%2.9%4.9%551,409
Recreational activity2.3%1.5%3.0%321,409
Skateboard/rollerblade1.7%1.0%2.4%241,409
Assault4.0%3.0%5.1%571,409
Suicide/suicide attempts1.8%1.1%2.5%261,409
Horse/rodeo1.3%0.7%2.0%191,409
Snow sports1.6%0.9%2.2%221,409
Team sports0.9%0.4%1.4%131,409
Other recreational vehicles****
Other2.4%1.6%3.2%341,409

Data Notes

ICD-10-CM codes for TBI Morbidity: S02.0, S02.1, S02.8, S02.91, S04.02, S04.03, S04.04, S06, S07.1, T74.4; ICD-10 codes for TBI Mortality: S01.0-S01.9, S02.0, S02.1, S02.3, S02.7-S02.9, S04.0, S06.0-S06.9, S07.0, S07.1, S07.8, S07.9, S09.7-S09.9, T01.0, T02.0, T04.0, T06.0, T90.1, T90.2, T90.4, T90.5, T90.8, T90.0. These cases may include a TBI alone or in combination with other injuries or conditions.   '' ''[[br]] [[br]] **Data have been suppressed and do not meet DHHS standards for reliability. [[br]] For more information, please go to [http://ibis.health.utah.gov/pdf/resource/DataSuppression.pdf]. Bicycle crashes include traffic- and non-traffic-related crashes. Cases of TBI with unknown etiology are not included in this chart. Causes of TBI as displayed in this chart are not mutually exclusive; that is, a single TBI could be sustained through a combination of these causes, in which case it would be counted in multiple categories. Numbers represent TBI-related deaths and hospitalizations and are extrapolated from the number of cases in a representative sample from the VIPP TBI database. The 2016-2017 TBI hospitalization and death sample is the most recent one available in the TBI database.

Data Source

Utah Department of Health and Human Services Office of Health Promotion and Prevention, Violence & Injury Prevention Program, TBI database

References and Community Resources

Centers for Disease Control and Prevention, Injury Center [[br]] [https://www.cdc.gov/injury/index.html] Utah Department of Health and Human Services, Violence and Injury Prevention Program, Traumatic Brain Injury [[br]] [https://vipp.utah.gov/traumatic-brain-injury/] Centers for Disease Control and Prevention, WISQARS: Web-based Injury Statistics Query and Reporting System [[br]] [https://www.cdc.gov/injury/wisqars/index.html]

More Resources and Links

Evidence-based community health improvement ideas and interventions may be found at the following sites:
  • Centers for Disease Control and Prevention (CDC) WONDER Database, a system for disseminating public health data and information.
  • United States Census Bureau data dashboard.
  • Utah healthy Places Index, evidence-based and peer-reviewed tool, supports efforts to prioritize equitable community investments, develop critical programs and policies across the state, and much more.
  • County Health Rankings
  • Kaiser Family Foundation's StateHealthFacts.org
  • Medical literature can be queried at PubMed library.



Page Content Updated On 11/30/2023, Published on 02/26/2024
The information provided above is from the Utah Department of Health and Human Services IBIS-PH web site (http://ibis.health.state.gov). The information published on this website may be reproduced without permission. Please use the following citation: " Retrieved Thu, 28 March 2024 9:06:37 from Utah Department of Health and Human Services, Indicator-Based Information System for Public Health Web site: http://ibis.health.state.gov ".

Content updated: Mon, 26 Feb 2024 10:48:16 MST