title: Rural prehospital trauma systems improve trauma outcome in low-income countries: a prospective study from North Iraq and Cambodia.
abstract: BACKGROUND
  A five-year prospective study was conducted in North Iraq and Cambodia to test a model for rural prehospital trauma systems in low-income countries.
  
  
  RESULTS
  From 1997 to 2001, 135 local paramedics and 5,200 lay First Responders were trained to provide in-field trauma care. The study population comprised 1,061 trauma victims with mean evacuation time 5.7 hours. The trauma mortality rate was reduced from pre-intervention level at 40% to 14.9% over the study period (95% CI for difference 17.2-33.0%). There was a reduction in trauma deaths from 23.9% in 1997 to 8.8% in 2001 (95% CI for difference 7.8-22.4%), and a corresponding significant improvement of treatment effect by year. The rate of infectious complications remained at 21.5 percent throughout the study period.
  
  
  CONCLUSIONS
  Low-cost rural trauma systems have a significant impact on trauma mortality in low-income countries.
authors.affiliation: Tromsoe Mine Victim Resource Center, Norway. hhusus@enitel.no
authors.forename: Hans
authors.initials: H
authors.lastname: Husum
authors.forename: Mads
authors.initials: M
authors.lastname: Gilbert
authors.forename: Torben
authors.initials: T
authors.lastname: Wisborg
authors.forename: Yang
authors.initials: Y
authors.lastname: Van Heng
authors.forename: Mudhafar
authors.initials: M
authors.lastname: Murad
mesh_terms: D000293:Adolescent; D000328:Adult; D000488:Allied Health Personnel / Q000193:education; D001753:Blast Injuries / Q000145:classification / Q000401:mortality / Q000628:therapy*; D002160:Cambodia / Q000453:epidemiology; D002648:Child; D003906:Developing Countries; D004632:Emergency Medical Services / Q000458:organization & administration*; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D007318:Inservice Training; D007493:Iraq / Q000453:epidemiology; D008297:Male; D010043:Outcome and Process Assessment, Health Care; D011446:Prospective Studies; D012041:Regional Medical Programs / Q000458:organization & administration*; D019035:Rural Health Services / Q000458:organization & administration*; D016019:Survival Analysis; D013663:Teaching / Q000379:methods; D013997:Time Factors; D014946:Wound Infection