Demographic and geographical characteristics of pediatric trauma in Scotland

Area of Science:

• Pediatric trauma care
• Healthcare system analysis
• Geospatial epidemiology

Background:

• Trauma systems demonstrably reduce mortality and enhance functional outcomes in injured patients.
• Understanding pediatric trauma patient demographics and geographic distribution is key to optimizing care.
• Scotland currently lacks a dedicated pediatric trauma system.

Purpose of the Study:

• To analyze the demographic and geospatial characteristics of pediatric trauma patients in Scotland.
• To determine the level of healthcare facility to which injured children are transported.
• To assess the need for and feasibility of establishing a pediatric trauma system in Scotland.

Main Methods:

• Retrospective analysis of pediatric trauma incidents (ages 1-14) attended by the Scottish Ambulance Service from 2008-2010.
• Geospatial analysis using postcode data to determine incident location by health board, rurality, and socioeconomic deprivation.
• Classification of destination healthcare facilities into six categories based on available services.

Main Results:

• Over 10,000 incidents were analyzed, with most occurring in urban areas (72.3%).
• Incident location correlated with socioeconomic deprivation.
• Only 11.6% of pediatric trauma patients were transported to a pediatric hospital with intensive care, while 50.2% went to adult hospitals without pediatric surgical services.

Conclusions:

• The majority of pediatric trauma incidents occur in urban settings.
• A significant proportion of injured children (50%) are treated at facilities lacking essential pediatric surgical services.
• No significant physiological differences were observed between children with normal versus deranged physiology in relation to outcomes or destination.