Geography matters: Variations in neck trauma between urban and rural level-II trauma centers

Geodemographic factors create divergent clinical patterns between urban and rural settings. Level-II trauma centers are a vital trauma-care infrastructure for both urban and rural communities. This study compares neck trauma patterns, resource utilization, and outcomes at these distinct geodemographic nodes.

Retrospective analysis (2014-2024) of neck trauma at an urban center (UC, n = 65) and a rural center (RC, n = 60). Demographics, mechanism, treatments, interventions, and outcomes were analyzed.

RC patients sustained more blunt, transport-related multisystem trauma with higher ISS. UC patients predominantly presented with localized penetrating injuries. Rural patients had higher ICU admission rates, longer ICU stays, more transfers to level-I centers yet underwent fewer operative interventions, invasive airway procedures, and CT angiogrophy.

There are significant variations in neck trauma between urban and rural level-II trauma centers. An "intervention paradox" exists were rural centers stabilize high-severity blunt trauma for transfer, while urban centers provide definitive care for penetrating wounds. These findings necessitate geodemographically tailored protocols. Understanding geodemographic variations is a critical aspect of optimizing trauma systems.

II Retrospective cohort.