Increased Risk of Fatal Paediatric Injuries in Rural Northern Norway

Overview

Journal Acta Anaesthesiol Scand

Specialty Anesthesiology

Date 2019 May 11

PMID 31074013

Citations 2

Authors

June A Holter

Torben Wisborg

Affiliations

Soon will be listed here.

Abstract

Background: Finnmark, Northern Norway, had a mortality rate for paediatric injury in 1998-2007 that was more than twice the national average. We investigated whether this rate had decreased in 2008-2015 after improvements in emergency care. We also compared the mortality rate to rates of non-fatal injury and trauma team activation both regionally and in Norway.

Methods: The study was based on 4 national registries. Mortality and injury rates were calculated per 100 000 persons per year. The study population was divided into age groups; 0-5, 6-10, 11-15 and 16-17 years.

Results: Between 1998-2007 and 2008-2015 there was an overall decrease in paediatric mortality rate due to external causes in Norway in total from 7.1 to 4.0. Despite this, in 2008-2015, the mortality rate remained 2.5 times higher in Finnmark than in Norway (9.7, RR = 2.5 CI 1.4-4.3, P = 0.001), similar to findings for 1998-2007. Finnmark had half the rate of non-fatal injuries in 1999-2007 (5052, RR = 0.6, 95% CI 0.6-0.7, P < 0.001) and in 2008-2015 (3893, RR = 0.5, 95% CI 0.5-0.6, P < 0.001) as in Norway. The rate of trauma team activation was similar in Finnmark and Norway.

Conclusions: The risk of injury-related death remained significantly higher, while the overall risk of non-fatal injury was significantly reduced for children in rural Northern Norway. Thus, injuries in this rural area seem to be less frequent but more severe. There is a need for detailed examination of each death to determine possible preventive measures.

Citing Articles

Mortality after paediatric emergency calls for patients with or without pre-existing comorbidity: a nationwide population based cohort study.

Nielsen V, Sovso M, Skals R, Bender L, Corfield A, Lossius H Scand J Trauma Resusc Emerg Med. 2024; 32(1):48.

PMID: 38807153 PMC: 11134704. DOI: 10.1186/s13049-024-01212-2.

Increased risk of fatal paediatric injuries in rural Northern Norway.

Holter J, Wisborg T Acta Anaesthesiol Scand. 2019; 63(8):1089-1094.

PMID: 31074013 PMC: 6767509. DOI: 10.1111/aas.13384.

References

Larsen K, Uleberg O, Skogvoll E . Differences in trauma team activation criteria among Norwegian hospitals. Scand J Trauma Resusc Emerg Med. 2010; 18:21. PMC: 2874509. DOI: 10.1186/1757-7241-18-21. View

Holter J, Wisborg T . Increased risk of fatal paediatric injuries in rural Northern Norway. Acta Anaesthesiol Scand. 2019; 63(8):1089-1094. PMC: 6767509. DOI: 10.1111/aas.13384. View

Kristiansen T, Rehn M, Gravseth H, Lossius H, Kristensen P . Paediatric trauma mortality in Norway: a population-based study of injury characteristics and urban-rural differences. Injury. 2011; 43(11):1865-72. DOI: 10.1016/j.injury.2011.08.011. View

Kim K, Ozegovic D, Voaklander D . Differences in incidence of injury between rural and urban children in Canada and the USA: a systematic review. Inj Prev. 2012; 18(4):264-71. DOI: 10.1136/injuryprev-2011-040306. View

Ovalle V, Pomerantz W, Anderson B, Gittelman M . Severe unintentional injuries sustained by Ohio children: Is there urban/rural variation?. J Trauma Acute Care Surg. 2016; 81(4 Suppl 1):S14-9. DOI: 10.1097/TA.0000000000001179. View

Kristiansen T, Lossius H, Rehn M, Kristensen P, Gravseth H, Roislien J . Epidemiology of trauma: a population-based study of geographical risk factors for injury deaths in the working-age population of Norway. Injury. 2013; 45(1):23-30. DOI: 10.1016/j.injury.2013.07.007. View

Bakke H, Hansen I, Bendixen A, Morild I, Lilleng P, Wisborg T . Fatal injury as a function of rurality-a tale of two Norwegian counties. Scand J Trauma Resusc Emerg Med. 2013; 21:14. PMC: 3599718. DOI: 10.1186/1757-7241-21-14. View

Ertl A, Beyer K, Tarima S, Zhou Y, Groner J, Cassidy L . The spatial epidemiology of pediatric trauma: A statewide assessment. J Trauma Acute Care Surg. 2017; 83(2):225-229. PMC: 5522352. DOI: 10.1097/TA.0000000000001523. View

Wisborg T, Hoylo T, Siem G . Death after injury in rural Norway: high rate of mortality and prehospital death. Acta Anaesthesiol Scand. 2003; 47(2):153-6. DOI: 10.1034/j.1399-6576.2003.00021.x. View

10.

Skjerven-Martinsen M, Naess P, Hansen T, Gaarder C, Lereim I, Stray-Pedersen A . A prospective study of children aged <16 years in motor vehicle collisions in Norway: severe injuries are observed predominantly in older children and are associated with restraint misuse. Accid Anal Prev. 2014; 73:151-62. DOI: 10.1016/j.aap.2014.09.004. View

11.

Vane D, Shackford S . Epidemiology of rural traumatic death in children: a population-based study. J Trauma. 1995; 38(6):867-70. DOI: 10.1097/00005373-199506000-00006. View

12.

Gomez D, Berube M, Xiong W, Ahmed N, Haas B, Schuurman N . Identifying targets for potential interventions to reduce rural trauma deaths: a population-based analysis. J Trauma. 2009; 69(3):633-9. DOI: 10.1097/TA.0b013e3181b8ef81. View

13.

Bakke H, Wisborg T . Rural high north: a high rate of fatal injury and prehospital death. World J Surg. 2011; 35(7):1615-20. PMC: 3140949. DOI: 10.1007/s00268-011-1102-y. View

14.

Fatovich D, Jacobs I . The relationship between remoteness and trauma deaths in Western Australia. J Trauma. 2008; 67(5):910-4. DOI: 10.1097/TA.0b013e3181815a26. View

15.

Rimsza M, Schackner R, Bowen K, Marshall W . Can child deaths be prevented? The Arizona Child Fatality Review Program experience. Pediatrics. 2002; 110(1 Pt 1):e11. DOI: 10.1542/peds.110.1.e11. View