title: Mortality in rural locations after severe injuries from motor vehicle crashes.
abstract: BACKGROUND
  Mortality from traffic crashes is often higher in rural regions, and this may be attributable to decreased survival probability after severe injury.
  
  
  METHODS
  Data were obtained from the National Automotive Sampling System - General Estimates System (NASS-GES) for 2002-2008. Using weighted survey logistic regression, three injury outcomes were analyzed: (a) Death overall, (b) Severe injury (incapacitating or fatal), and (c) Death, after severe injury. Models controlled for (pre-crash) person, event, and county level factors.
  
  
  RESULTS
  The sample included 883,473 motorists. Applying weights, this represented a population of 98,411,993. Only 2% of the weighted sample sustained a severe injury, and 9% of these severely injured motorists died. The probability of death overall and the probability of severe injury increased with older age, safety belt nonuse, vehicle damage, high speed, and early morning crashes . Males were less likely to be severely injured, but more likely to die if severely injured. Motorists in southern states were more likely to have severe injuries, but not more likely to die if severely injured. Motorists who crashed in very rural counties were significantly more likely to die overall, and were more likely to die if severely injured.
  
  
  CONCLUSIONS
  Motorists with severe injury are more likely to die in rural areas, after controlling for person- and event-specific factors.
authors.affiliation: Center for Outcomes Research and Evaluation, Maine Medical Center, Portland ME, USA. travil1@mmc.org
authors.forename: Lori L
authors.initials: LL
authors.lastname: Travis
authors.forename: David E
authors.initials: DE
authors.lastname: Clark
authors.forename: Amy E
authors.initials: AE
authors.lastname: Haskins
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Kilch
mesh_terms: D000063:Accidents, Traffic / Q000401:mortality*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D015601:Injury Severity Score; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D018986:Motor Vehicles; D011336:Probability; D012307:Risk Factors; D012424:Rural Population; D014481:United States / Q000453:epidemiology; D014947:Wounds and Injuries / Q000401:mortality*; D055815:Young Adult