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The spatial epidemiology of pediatric trauma: A statewide assessment. J Trauma Acute Care Surg 2017 08;83(2):225-229

Date

04/20/2017

Pubmed ID

28422922

Pubmed Central ID

PMC5522352

DOI

10.1097/TA.0000000000001523

Scopus ID

2-s2.0-85017620256   1 Citation

Abstract

BACKGROUND: Despite significant advances in the prevention and treatment of pediatric trauma, preventable injuries continue to burden the lives of millions of children. To target prevention strategies, it is critical to identify areas with high burdens of pediatric trauma. Therefore, this study analyzed statewide data from the Ohio Trauma Registry from 2007 to 2012 to identify geographical patterns in pediatric injury.

METHODS: Data from the first hospital of care for 16,330 pediatric trauma patients younger than 16 years were analyzed using the disease mapping method adaptive spatial filtering to estimate a series of maps that display age- and sex-adjusted rates of pediatric trauma, severe trauma, and standardized mortality ratios while controlling for population size to create stable estimates throughout the study area. The locations of all trauma centers were mapped to highlight access to trauma care.

RESULTS: Areas with significantly higher than expected rates of severe injury were identified in nonurban areas, where children lacked timely access to a pediatric trauma center or Level I adult trauma center. Although highest standardized mortality ratios were in urban areas, nonurban areas experienced elevated mortality with rates over four times higher than expected.

CONCLUSION: Areas with higher than expected age- and sex-adjusted rates of severe injury and mortality should be further explored to identify opportunities for injury prevention and appropriate access to timely care.

LEVEL OF EVIDENCE: Epidemiologic study, level III.

Author List

Ertl AM, Beyer KMM, Tarima S, Zhou Y, Groner JI, Cassidy LD

Authors

Kirsten M. Beyer PhD, MPH Associate Professor in the Institute for Health and Equity department at Medical College of Wisconsin
Laura Cassidy PhD Professor in the Institute for Health and Equity department at Medical College of Wisconsin
Sergey S. Tarima PhD Associate Professor in the Institute for Health and Equity department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adolescent
Appalachian Region
Child
Child, Preschool
Cross-Sectional Studies
Female
Geography
Health Services Accessibility
Humans
Infant
Infant, Newborn
Injury Severity Score
Male
Ohio
Patient Admission
Population Surveillance
Registries
Rural Population
Trauma Centers
Urban Population
Wounds and Injuries
jenkins-FCD Prod-486 e3098984f26de787f5ecab75090d0a28e7f4f7c0