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. 2018 Jul 28;11(1):519.
doi: 10.1186/s13104-018-3639-4.

Rural versus urban pediatric non-accidental trauma: different patients, similar outcomes

Ashley P Marek  1 , Rachel M Nygaard  2 , Ellie M Cohen  1 , Stephanie F Polites  3 , Anne-Marie E Sirany  1 , Sarah E Wildenberg  1 , Terri A Elsbernd  3 , Sherrie Murphy  1 , D Dean Potter  3 , Martin D Zielinski  3 , Chad J Richardson  1
Affiliations

Rural versus urban pediatric non-accidental trauma: different patients, similar outcomes

Ashley P Marek et al. BMC Res Notes. .

Abstract

Objective: Our aim was to compare urban and rural non-accidental trauma for trends and characterize where injury prevention efforts can be focused. Pediatric trauma patients (age 0-14 years) at two level I adult and pediatric trauma centers, one rural and one urban, were included and data from the trauma registries at each center was abstracted.

Results: Of 857 pediatric admissions, 10% of injuries were considered non-accidental. The mean age for all non-accidental trauma patients was significantly lower than the overall pediatric trauma population (2.6 vs. 7.7 years, P < 0.001). Significantly more fatalities occurred in the non-accidental trauma cohort (5.7% vs. 1% P = 0.007). In nearly half of all non-accidental trauma patients, the primary insurance was government programs (49%) and 46% were commercial insurance. The proportion of government insurance in non-accidental trauma was higher in both urban and rural cohorts. There were similar rates of urban and rural patients sustaining non-accidental trauma who were uninsured (6.5 vs. 5.3%). Patients that were younger, in a rural location, and receiving government insurance were at higher risk of non-accidental trauma on univariable analysis. However, only age remained an independent predictor on multivariable analysis.

Keywords: Intentional trauma; Non-accidental trauma; Pediatric injury; Pediatric trauma; Rural injury; Urban injury.

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