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

Area of Science:

• Pediatric Trauma Research
• Injury Prevention Science
• Public Health Surveillance

Background:

• Non-accidental trauma (NAT) in children is a significant public health concern.
• Understanding urban vs. rural disparities in NAT is crucial for targeted interventions.
• Previous research indicates varying risk factors, but urban-rural comparisons require further investigation.

Purpose of the Study:

• To compare urban and rural pediatric non-accidental trauma.
• To identify trends and risk factors for NAT in different geographic settings.
• To inform focused injury prevention strategies for non-accidental trauma.

Main Methods:

• Retrospective analysis of pediatric trauma patients (0-14 years) at urban and rural Level I trauma centers.
• Data abstracted from trauma registries.
• Comparison of demographic, insurance, and outcome data between urban and rural cohorts.

Main Results:

• 10% of 857 pediatric admissions were non-accidental trauma.
• NAT patients were significantly younger (mean 2.6 vs. 7.7 years) with higher mortality (5.7% vs. 1%).
• Younger age, rural location, and government insurance were associated with higher NAT risk on univariable analysis, but only age remained significant on multivariable analysis.

Conclusions:

• Pediatric non-accidental trauma disproportionately affects younger children.
• While rural location and government insurance are risk factors, age is the strongest independent predictor.
• Injury prevention efforts should prioritize younger children, with consideration for geographic and socioeconomic factors.