Dataset Information

Profile of trauma mortality and trauma care resources at rural emergency departments and urban trauma centres in Quebec: a population-based, retrospective cohort study.

ABSTRACT:

Objectives

As 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.

Design

Retrospective cohort study.

Setting

26 rural EDs and 33 level 1 and 2 urban trauma centres in Quebec, Canada.

Participants

79?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.

Results

Overall, 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.

Conclusions

Trauma 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.

SUBMITTER: Fleet R

PROVIDER: S-EPMC6549736 | biostudies-literature | 2019 Jun

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Profile of trauma mortality and trauma care resources at rural emergency departments and urban trauma centres in Quebec: a population-based, retrospective cohort study.

Fleet Richard R Lauzier François F Tounkara Fatoumata Korinka FK Turcotte Stéphane S Poitras Julien J Morris Judy J Ouimet Mathieu M Fortin Jean-Paul JP Plant Jeff J Légaré France F Dupuis Gilles G Turgeon-Pelchat Catherine C

BMJ open 20190602 6

<h4>Objectives</h4>As 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.<h4>Design</h4>Retrospective cohort study.<h4>Setting</h4>26 rural EDs and 33 level 1 and 2 urb ...[more]

PMID: 31160276

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Dataset Information

Profile of trauma mortality and trauma care resources at rural emergency departments and urban trauma centres in Quebec: a population-based, retrospective cohort study.

Objectives

Design

Setting

Participants

Primary and secondary outcome measures

Results

Conclusions

Publications

Profile of trauma mortality and trauma care resources at rural emergency departments and urban trauma centres in Quebec: a population-based, retrospective cohort study.

Similar Datasets

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