Observational studyScandinavian journal of trauma, resuscitation and emergency medicine2015
Short-term outcome and differences between rural and urban trauma patients treated by mobile intensive care units in Northern Finland: a retrospective analysis.
Observational study in Scandinavian journal of trauma, resuscitation and emergency medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Factors Impacting Patient Outcomes Associated with Use of Emergency Medical Services Operating in Urban Versus Rural Areas: A Systematic Review.International journal of environmental research and public health · 2019Pooled it
- Article
- Variation in global trauma care: a survey of 187 hospitals across 51 countries.BMJ global health · 2025Article
- Prehospital Time Interval for Urban and Rural Emergency Medical Services: A Systematic Literature Review.Healthcare (Basel, Switzerland) · 2022Review
- Factors associated with EMS on-scene time and its regional difference in road traffic injuries: a population-based observational study.BMC emergency medicine · 2022Observational
- Health Care Resources and 24,910 Deaths Due to Traffic Accidents: An Ecological Mortality Study in Poland.International journal of environmental research and public health · 2021Article
- A scoping review of worldwide studies evaluating the effects of prehospital time on trauma outcomes.International journal of emergency medicine · 2020Article
- The reliability and accuracy of operational system data in a nationwide helicopter emergency medical services mission database.BMC emergency medicine · 2019Article
- Loss of life years due to unavailable helicopter emergency medical service: a single base study from a rural area of Norway.Scandinavian journal of primary health care · 2019Article
- Helicopter Emergency Medical Service (HEMS) Response in Rural Areas in Poland: Retrospective Study.International journal of environmental research and public health · 2019Article
- Human and equipment resources for difficult airway management, airway education programs, and capnometry use in Japanese emergency departments: a nationwide cross-sectional study.International journal of emergency medicine · 2017Article
- The Current State of Rural Neurosurgical Practice: An International Perspective.Journal of neurosciences in rural practiceReview
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEmergency medical services are an important part of trauma care, but data comparing urban and rural areas is needed. We compared 30-day mortality and length of intensive care unit (ICU) stay for trauma patients injured in rural and urban municipalities and collected basic data on trauma care in Northern Finland.
methodsWe examined data from all trauma patients treated by the Finnish Helicopter Emergency Medical Services in 2012 and 2013. Only patients surviving to hospital were included in the analysis but all pre-hospital deaths were recorded. All data was retrieved from the national Helicopter Emergency Medical Services database, medical records, and the Finnish Causes of Death Registry. Patients were defined as urban or rural depending on the type of municipality where the injury occurred.
resultsA total of 472 patients were included. Age and Injury Severity Score did not differ between rural and urban patients. The pre-hospital time intervals and distances to trauma centers were longer for rural patients and a larger proportion of urban patients had intentional injuries (23.5% vs. 9.3%, P <0.001). The 30-day mortality for severely injured patients (Injury Severity Score >15) was 23.9% in urban and 13.3% in rural municipalities. In the multivariate regression analysis the odds ratio (OR) for 30-day mortality was 2.8 (95% confidence interval 1.0 to 7.9, P = 0.05) in urban municipalities. There was no difference in the length of ICU stay or scores. Twenty patients died on scene or during transportation and 56 missions were aborted because of pre-hospital death.
conclusionsThe severely injured urban trauma patients had a trend toward higher 30-day mortality compared with patients injured in rural areas but the length of ICU stay was similar. However, more pre-hospital deaths occurred in rural municipalities. The time before mobile ICU arrival appears to be critical for trauma patients' survival, especially in rural areas.
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