Urban vs rural pediatric trauma in Alberta: where can we focus on prevention?
OBJECTIVE
Understanding differences between rural and urban pediatric trauma is important in establishing preventative strategies specific to each setting.


METHODS
Data were extracted from a Provincial Pediatric Trauma Registry on pediatric patients (0-17 years) with Injury Severity Scores (ISS) 12 or more, treated from 1996 to 2006 at 5 major trauma centers in the province. Urban and rural patients were compared with respect to demographic data, as well as injury type and severity. Statistical analysis was made using SPSS software (SPSS Inc, Chicago, Ill) by chi(2), Fisher's Exact test, or t test with P < .05 considered significant.


RESULTS
Of n = 2660, 63.3% rural patients predominate; mean ISS was 22.5. However, rural patients had more severe injuries (ISS, 23.2 vs 21.8; P < .0001). Blunt trauma was the most common mechanism overall (urban, 89.6%; rural, 93.2%), with most being motor vehicle accidents (MVAs). Significantly, more penetrating trauma occurred in the urban setting (5.4% vs 2.6%; P < .0001). Intent injuries were more common in the urban setting (15.2% vs 5.5%). Of the patients, 89.2% survived the trauma. However, urban patients had a higher rate of death than rural ones (13.0% vs 10.5%; P < .05).


CONCLUSIONS
Despite the finding that rural patients sustained more severe injuries, overall survival was actually better when compared with urban patients. Most injuries were blunt trauma, suggesting road safety should be the main target in prevention strategies. Intent injuries were much higher in the urban group, thus, a need to target violence in urban prevention strategies.
Mihalicz
Dana
D
Faculty of Medicine, Department of Pediatric General Surgery, University of Alberta, Stollery Children's Hospital, Edmonton, Alberta, Canada T6G 2B7.
Phillips
Leah
L
Bratu
Ioana
I
D000293:Adolescent; D017677:Age Distribution; D000416:Alberta / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015601:Injury Severity Score; D012189:Retrospective Studies; D012424:Rural Population; D017678:Sex Distribution; D015996:Survival Rate; D014505:Urban Population; D014947:Wounds and Injuries / Q000453:epidemiology / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*