title: Feasibility and utility of population-level geospatial injury profiling: prospective, national cohort study.
abstract: BACKGROUND
  Geospatial analysis is increasingly being used to evaluate the design and effectiveness of trauma systems, but there are no metrics to describe the geographic distribution of incidents. The aim of this study, therefore, was to evaluate the feasibility and utility of using spatial analysis to characterize, at scale, the geospatial profile of an injured population.
  
  
  METHODS
  This is a prospective national cohort study of all trauma patients attended to by the Scottish Ambulance Service in a complete year (between July 1, 2013, and June 30, 2014). Incident location and severity were collected at source. Incident distribution was evaluated using geostatistical techniques.
  
  
  RESULTS
  There were 80,391 recorded incidents involving traumatic injury. Incident density was highest in the central Southern part of the country and along the East coast, broadly following the population distribution and road network. The overall distribution was highly clustered, and centered on the central Southern and Eastern parts of the country. When analyzed by triage category, the distribution of incidents triaged to major trauma center care was slightly less clustered than that of incidents triaged to trauma unit or local emergency hospital care, but the spread was similar. When analyzed by type of injury, assaults and falls were more clustered than incidents relating to traffic and transportation.
  
  
  CONCLUSIONS
  This study demonstrates the feasibility and power of describing the geographic distribution of a group of injured patients. The methodology described has potential application for injury surveillance and trauma system design and evaluation.
authors.affiliation: From the Departments of Surgery (J.O.J.) and Intensive Care Medicine (J.O.J.), Aberdeen Royal Infirmary & Health Services Research Unit (J.O.J.,M.K.C.), and Department of Geography and Environment (D.R.G.), University of Aberdeen, Aberdeen; Academic Unit of Surgery (J.J.M.), Glasgow Royal Infirmary, Glasgow City; School of Computer Science (S.H.), University of Birmingham, West Midlands; and Scottish Ambulance Service (R.L)., Edinburgh, United Kingdom; and Key Lab of Intelligent Perception and Image Understanding (H.W.), Ministry of Education, Xidian University, Xi'an, China.
authors.forename: Jan O
authors.initials: JO
authors.lastname: Jansen
authors.forename: Jonathan J
authors.initials: JJ
authors.lastname: Morrison
authors.forename: Handing
authors.initials: H
authors.lastname: Wang
authors.forename: Shan
authors.initials: S
authors.lastname: He
authors.forename: Robin
authors.initials: R
authors.lastname: Lawrenson
authors.forename: Marion K
authors.initials: MK
authors.lastname: Campbell
authors.forename: David R
authors.initials: DR
authors.lastname: Green
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000552:Ambulances / Q000706:statistics & numerical data*; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods*; D011446:Prospective Studies; D012606:Scotland / Q000453:epidemiology; D014193:Trauma Centers / Q000458:organization & administration*; D015599:Trauma Severity Indices; D014218:Triage / Q000706:statistics & numerical data*; D014947:Wounds and Injuries / Q000453:epidemiology*