ArticleBMJ open2019
Profile of trauma mortality and trauma care resources at rural emergency departments and urban trauma centres in Quebec: a population-based, retrospective cohort study.
Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed.
- The Omission of Nursing Care in Emergency Departments: A Conceptual Analysis Using Walker & Avant's Methodology.Journal of advanced nursing · 2026Review
- Rural Emergency 360°: A mixed-methods analysis of barriers and priorities for equitable emergency care in Québec.PloS one · 2026Article
- A Twelve-Year Retrospective Analysis of a Journey Towards Rural Level I Trauma Center Verification.Open access emergency medicine : OAEM · 2026Article
- Integrated Multidisciplinary and Digital Innovation in Polytrauma: Optimizing Whole-Process Emergency Models for Secondary Hospitals.Open access emergency medicine : OAEM · 2026Review
- Disparities in Access to Trauma Care in Canada: A Geospatial Analysis of Census Data.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2025Article
- Variation in global trauma care: a survey of 187 hospitals across 51 countries.BMJ global health · 2025Article
- Blood deserts in a universal health system: Addressing structural inequities in northern Canada.Transfusion · 2025Article
- The association between remoteness of injury and in-hospital mortality for motor vehicle collision major trauma patients: evidence of survivor bias in an analysis of registry data.Injury epidemiology · 2025Article
- Assessment of Emergency and Trauma Stabilization Training in Family Medicine Residency Programs: A CERA Study.Family medicine · 2025Article
- Intentional transit practice through a nearby hospital for remote area emergencies provides earlier primary care than helicopter emergency medical services alone in rural emergencies: a single-center, observational study.Journal of rural medicine : JRM · 2025Article
- Should an emergency physician be a "surgeon" in a rural area? A case of blunt cardiac rupture successfully treated by an emergency physician.Journal of rural medicine : JRM · 2024Article
- Through the big top: An exploratory study of circus-based artistic knowledge translation in rural healthcare services, Québec, Canada.PloS one · 2024Article
- Accelerating the Front End of Medicine: Three Digital Use Cases and HCI Implications.Healthcare (Basel, Switzerland) · 2022Article
- Assessing Trauma Management in Urban and Rural Populations in Norway: A National Register-Based Research Protocol.JMIR research protocols · 2022Article
- Disparities in rural versus urban field triage: Risk and mitigating factors for undertriage.The journal of trauma and acute care surgery · 2020Article
- Article
- A Canadian Rural Living Lab Hospital: Implementing solutions for improving rural emergency care.Future healthcare journal · 2020Article
- Improving delivery of care in rural emergency departments: a qualitative pilot study mobilizing health professionals, decision-makers and citizens in Baie-Saint-Paul and the Magdalen Islands, Québec, Canada.BMC health services research · 2020Article
- Canadian in-hospital mortality for patients with emergency-sensitive conditions: a retrospective cohort study.BMC emergency medicine · 2019Article
- A Canadian consensus-based list of urgent and specialized in-hospital trauma care interventions to assess the accuracy of prehospital trauma triage protocols: a modified Delphi study.Canadian journal of surgery. Journal canadien de chirurgieReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesAs Canada's second largest province, the geography of Quebec poses unique challenges for trauma management. Our primary objective was to compare mortality rates between trauma patients treated at rural emergency departments (EDs) and urban trauma centres in Quebec. As a secondary objective, we compared the availability of trauma care resources and services between these two settings.
designRetrospective cohort study.
setting26 rural EDs and 33 level 1 and 2 urban trauma centres in Quebec, Canada.
participants79 957 trauma cases collected from Quebec's trauma registry. PRIMARY AND SECONDARY OUTCOME MEASURES: Our primary outcome measure was mortality (prehospital, ED, in-hospital). Secondary outcome measures were the availability of trauma-related services and staff specialties at rural and urban facilities. Multivariable generalised linear mixed models were used to determine the relationship between the primary facility and mortality.
resultsOverall, 7215 (9.0%) trauma patients were treated in a rural ED and 72 742 (91.0%) received treatment at an urban centre. Mortality rates were higher in rural EDs compared with urban trauma centres (13.3% vs 7.9%, p<0.001). After controlling for available potential confounders, the odds of prehospital or ED mortality were over three times greater for patients treated in a rural ED (OR 3.44, 95% CI 1.88 to 6.28). Trauma care setting (rural vs urban) was not associated with in-hospital mortality. Nearly all of the specialised services evaluated were more present at urban trauma centres.
conclusionsTrauma patients treated in rural EDs had a higher mortality rate and were more likely to die prehospital or in the ED compared with patients treated at an urban trauma centre. Our results were limited by a lack of accurate prehospital times in the trauma registry.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.