Scottish urban versus rural trauma outcome study

Area of Science:

• Trauma care research
• Health services research
• Rural health outcomes

Background:

• Healthcare access and outcomes following trauma are critical for planning.
• Limited resources necessitate high-quality data for effective healthcare strategies.
• This study compares trauma patient outcomes in urban versus rural Scotland.

Purpose of the Study:

• To compare health outcomes for patients with significant trauma in urban and rural settings in Scotland.
• To provide data for informed healthcare planning and resource allocation in trauma care.

Main Methods:

• A 2-year prospective observational study in West Scotland (2.58 million population).
• Primary outcomes: total inpatient days, intensive care unit (ICU) days, and mortality.
• Analysis of moderate (ISS 9-15) and major (ISS>15) trauma patients using chi-square and Mann-Whitney U tests.

Main Results:

• 3,962 urban (85%) and 674 rural (15%) patients included.
• Rural patients had significantly longer prehospital times, more air ambulance transfers, and greater paramedic presence.
• No significant differences observed in total inpatient stay, ICU stay, or mortality between urban and rural patients.

Conclusions:

• Extended prehospital times in rural Scotland did not correlate with adverse outcomes (mortality, length of stay) for moderately and severely injured trauma patients.
• Findings support the potential for rationalizing trauma services in Scotland.
• Data highlights the need for continued evaluation of rural trauma care delivery models.