title: Fatal injuries in rural and urban areas in northern Finland: a 5-year retrospective study.
abstract: BACKGROUND
  Finland has the fourth highest injury mortality rate in the European Union. To better understand the causes of the high injury rate, and prevent these fatal injuries, studies are needed. Therefore, we set out to complete an analysis of the epidemiology of fatal trauma, and any contributory role for alcohol, long suspected to promote fatal injuries. As a study area, we chose the four northernmost counties of Finland; their mix of remote rural areas and urban centres allowed us to correlate mortality rates with 'rurality'.
  
  
  METHODS
  The Causes of Death Register was consulted to identify deaths from external causes over a 5-year time period. Data were retrieved from death certificates, autopsy reports and medical records. The municipalities studied were classified as either rural or urban.
  
  
  RESULTS
  Of 2915 deaths categorized as occurring from external causes during our study period, 1959 were eligible for inclusion in our study. The annual crude mortality rate was 54 per 100,000 inhabitants; this rate was higher in rural vs. urban municipalities (65 vs. 45 per 100,000 inhabitants/year). Additionally, a greater number of pre-hospital deaths from accidental high-energy trauma occurred in rural areas (78 vs. 69%). 42% of all pre-hospital deaths occurred under the influence of alcohol.
  
  
  CONCLUSIONS
  The crude mortality rate for fatal injuries was high overall as compared to other studies, and elevated in rural areas, where pre-hospital deaths were more common. Almost half of pre-hospital deaths occurred under the influence of alcohol.
authors.affiliation: Centre for Pre-Hospital Emergency Care, Oulu University Hospital, Oulu, Finland.|Department of Anesthesia and Intensive Care, Lapland Central Hospital, Rovaniemi, Finland.|Department of Anesthesiology and Intensive Care, Hammerfest Hospital, Finnmark Health Trust, Hammerfest, Norway.
authors.forename: L
authors.initials: L
authors.lastname: Raatiniemi
authors.affiliation: Anesthesia and Critical Care Research Group, University of Tromsø, Tromsø, Norway.
authors.forename: T
authors.initials: T
authors.lastname: Steinvik
authors.affiliation: Division of Intensive Care Medicine, Oulu University Hospital, Oulu, Finland.|Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland.
authors.forename: J
authors.initials: J
authors.lastname: Liisanantti
authors.affiliation: Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland.|Division of Operative Care, Oulu University Hospital, Oulu, Finland.
authors.forename: P
authors.initials: P
authors.lastname: Ohtonen
authors.affiliation: Centre for Pre-Hospital Emergency Care, Oulu University Hospital, Oulu, Finland.
authors.forename: M
authors.initials: M
authors.lastname: Martikainen
authors.affiliation: Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland.
authors.forename: S
authors.initials: S
authors.lastname: Alahuhta
authors.affiliation: Department of Gastroenterological Surgery, University Hospital North Norway, Tromsø, Norway.
authors.forename: T
authors.initials: T
authors.lastname: Dehli
authors.affiliation: Department of Anesthesiology and Intensive Care, Hammerfest Hospital, Finnmark Health Trust, Hammerfest, Norway.|Anesthesia and Critical Care Research Group, University of Tromsø, Tromsø, Norway.|Norwegian National Advisory Unit on Trauma, Oslo University Hospital, Oslo, Norway.
authors.forename: T
authors.initials: T
authors.lastname: Wisborg
authors.affiliation: Anesthesia and Critical Care Research Group, University of Tromsø, Tromsø, Norway.|Mo i Rana Hospital, Helgeland Hospital Trust, Mo i Rana, Norway.
authors.forename: H K
authors.initials: HK
authors.lastname: Bakke
mesh_terms: D000059:Accidents; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000453:epidemiology; D002423:Cause of Death; D005260:Female; D005387:Finland / Q000453:epidemiology; D005843:Geography; D006801:Humans; D015994:Incidence; D038801:International Classification of Diseases; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012424:Rural Population / Q000706:statistics & numerical data*; D013405:Suicide / Q000706:statistics & numerical data; D014505:Urban Population / Q000706:statistics & numerical data*; D014947:Wounds and Injuries / Q000401:mortality*