Traumatic deaths in children: is there a difference between urban and rural populations?

OBJECTIVE: Trauma is a leading cause of death among children. Detailed knowledge of the epidemiology of traumatic childhood deaths is necessary for allocating available treatment resources and for preventing injuries at both community and regional levels. To our knowledge, there has been no report comparing urban to rural pediatric deaths of this nature.
METHODS: A retrospective review of all deceased patients who were treated in an urban pediatric emergency department was performed. Patients were categorized into 2 groups, namely, urban versus rural, during analyses for comparison in this study.
RESULTS: A total of 1498 patients died at our institution during the study period, with 124 being attributable to an injury for a rate of 9.5 injury-related deaths per study period year. Overall, most injury-related deaths were accidental. Urban deaths involved younger patients and were more likely to be abusive and more likely to have been seen for an injury in a clinic or emergency department within 2 months of their death. Rural deaths involved older patients and were more likely to be a result of an accidental injury.
CONCLUSIONS: Patterns of injury have been linked with injury locales that can aid the emergency provider in the assessment of children who die as a result of injury. Despite the challenges involved, there is a clear need to further identify differences in patterns of fatal injuries in urban and rural areas and to better translate and evaluate prevention and intervention programs in rural communities.