Outcomes of pediatric trauma patients transported from rural and urban scenes

Air Med J. 2008 Mar-Apr;27(2):78-83. doi: 10.1016/j.amj.2007.10.001.


Objectives: Mortality differences exist between victims of urban and rural trauma. It is unknown if these differences persist in those patients who survive to HEMS transport. This study examined the in-hospital mortality, hospital LOS, and discharge status of pediatric blunt trauma victims transported by HEMS from rural and urban scenes.

Methods: Retrospective review of pediatric (< 17) transports between 1997 and 2001. 130 rural and 419 urban pediatric patients transported to area trauma centers were identified from HEMS and registry records.

Results: Total mileage, flight times, and scene times were significantly longer for rural flights (P < 0.05). There were no significant differences between the groups with regard to age, gender, vitals, hospital/ICU days, and mortality. After controlling for ISS and mechanism of injury, urban patients were 9 times more likely to die compared to rural patients.

Conclusions: Pediatric patients injured in urban areas had shorter total flight and scene times than pediatric patients flown from rural scenes. Higher adjusted in-hospital mortality rates in the urban group were likely a result of faster EMS response and transport times, which minimized out-of-hospital deaths. Factors prior to HEMS arrival may have more impact on the increased mortality rates of rural blunt trauma victims documented nationally.

Publication types

  • Comparative Study

MeSH terms

  • Accidents, Traffic / mortality
  • Adolescent
  • Air Ambulances / statistics & numerical data*
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Logistic Models
  • Male
  • Outcome Assessment, Health Care
  • Registries
  • Retrospective Studies
  • Rural Health Services / statistics & numerical data*
  • Time Factors
  • Transportation of Patients / statistics & numerical data*
  • Urban Health Services / statistics & numerical data*
  • Wounds, Nonpenetrating / complications
  • Wounds, Nonpenetrating / mortality*