A comparison of trauma patients in urban and rural areas presenting to a Canadian tertiary care centre.

IF 2.2 4区 医学 Q2 SURGERY Canadian Journal of Surgery Pub Date : 2024-08-27 Print Date: 2024-07-01 DOI:10.1503/cjs.013623
Samuel Savard, Lauren V Ready, Prosanta Mondal, Niroshan Sothilingam, Phil Davis
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Abstract

Background: The aim of our work was to examine differences between trauma patients in rural and urban areas who presented to a tertiary trauma centre in the province of Saskatchewan, Canada.

Methods: We identified a historical cohort of all level 1 trauma activations presenting to Royal University Hospital (RUH) from April 1, 2020, to March 31, 2022. We divided the cohort into 2 groups (urban and rural), according to the trauma location. The primary outcome of interest was 30-day mortality. Secondary outcomes of interest were hospital length of stay, readmission to hospital within 30 days of discharge, and complication rate.

Results: Trauma patients in rural areas were younger (34.1 v. 37 yr; p = 0.002) and more likely to be male (80.3% v. 74.4%; p = 0.040), with higher Injury Severity Scores (12.3 v. 8.3; p < 0.0001). Trauma patients in urban areas were more likely to sustain penetrating trauma (42.5% v. 28.5%; p < 0.0001). We saw no differences in morbidity and mortality between the 2 groups, but the rural trauma group had longer median lengths of stay (5 v. 3 d; p < 0.0007).

Conclusion: Although we identified key differences in patient demographics, injury type, and injury severity, outcomes were largely similar between the urban and rural trauma groups. This finding contradicts comparable studies within Canada and the United States, a difference that may be attributable to the lack of inclusion of prehospital mortality in the rural trauma group. The longer length of stay in trauma patients from rural areas may be attributed to disposition challenges for patients who live remotely.

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在加拿大一家三级医疗中心就诊的城市和农村地区创伤患者的比较。
背景:我们的工作旨在研究在加拿大萨斯喀彻温省一家三级创伤中心就诊的城乡创伤患者之间的差异:我们对 2020 年 4 月 1 日至 2022 年 3 月 31 日期间前往皇家大学医院(RUH)就诊的所有 1 级创伤患者进行了历史性分类。根据创伤地点,我们将队列分为两组(城市组和农村组)。主要研究结果是 30 天死亡率。次要研究结果为住院时间、出院后 30 天内再次入院情况以及并发症发生率:农村地区的创伤患者更年轻(34.1 岁对 37 岁;p = 0.002),更可能是男性(80.3% 对 74.4%;p = 0.040),受伤严重程度评分更高(12.3 对 8.3;p < 0.0001)。城市地区的创伤患者更有可能遭受穿透性创伤(42.5% 对 28.5%;P < 0.0001)。我们发现两组患者的发病率和死亡率没有差异,但农村创伤组患者的中位住院时间更长(5 天对 3 天;P < 0.0007):尽管我们发现了患者人口统计学、受伤类型和受伤严重程度方面的主要差异,但城市和农村创伤组的治疗结果基本相似。这一结果与加拿大和美国的同类研究相矛盾,这种差异可能是由于农村创伤组未纳入院前死亡率。农村地区的创伤患者住院时间较长,这可能是由于偏远地区的患者面临处置难题。
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来源期刊
CiteScore
3.00
自引率
8.00%
发文量
120
审稿时长
6-12 weeks
期刊介绍: The mission of CJS is to contribute to the meaningful continuing medical education of Canadian surgical specialists, and to provide surgeons with an effective vehicle for the dissemination of observations in the areas of clinical and basic science research.
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