Assessing Trauma Management in Urban and Rural Populations in Norway: A National Register-Based Research Protocol.

Area of Science:

• Emergency Medicine
• Trauma Surgery
• Public Health Policy

Background:

• Prehospital response time is a critical, yet debated, quality indicator in Norwegian trauma care.
• Centralization of trauma services and hospital closures have increased transport distances, particularly for rural patients.
• The impact of trauma system configuration on early trauma management in urban vs. rural areas is not well-described.

Purpose of the Study:

• To assess the initial pathways of injured patients through the Norwegian trauma system.
• To explore differences in prehospital time and trauma care between rural and central Norwegian areas.
• To provide evidence for the optimal organization of trauma care, considering prehospital time.

Main Methods:

• Retrospective cohort studies utilizing data from the Norwegian Trauma Registry (NTR) and a local Emergency Medical Communications Center.
• Inclusion of all injured patients registered in the NTR between January 1, 2015, and December 31, 2020.
• Statistical analysis, including regression, to compare prehospital times in rural and central areas, adjusting for confounders.

Main Results:

• Data extraction for approximately 40,000 trauma patients is planned for Q1 2022.
• Analysis will commence immediately after data extraction, with results anticipated from Q3 2022.
• The study received funding in fall 2020 and ethical approval from Oslo University Hospital.

Conclusions:

• Study findings will enhance understanding of existing quality indicators in trauma care.
• Results will inform the ongoing development of the Norwegian trauma system amidst hospital centralization.
• Expected high generalizability to other high-income countries with similar demographic and trauma system trends.