Abstract
Background: Geographical variations in case volume have important implications for trauma system configuration, and have been recognised for some time. However, temporal trends in these distributions have received relatively little attention. The aim of this study was to propose a model to facilitate the spatio-temporal surveillance of injuries, using Scotland as a case study.
Methods: Retrospective analysis of five years’ (2009-2013) of trauma incident location data. We analysed the study population as a whole, as well as predefined subgroups, such as those with abnormal physiological signs. In order to leverage sufficient statistical power to detect temporal trends in rare events over short time periods and small spatial units, we used a geographically weighted regression model.
Results: There were 509,725 incidents. There were increases in case volume in Glasgow, the central Southern part of the country, the Northern parts of the Highlands, the North-East, and the Orkney and Shetland Islands. Statistically significant changes were mostly restricted to major cities. Decreases in the number of incidents were seen in the Hebrides, Western Scotland, Fife and Lothian, and the Borders. Statistically significant changes were seen mostly in Fife and Lothian, the West, some areas of the Borders, and in the Peterhead area. Subgroup analyses showed markedly different spatio-temporal patterns.
Conclusions: This project has demonstrated the feasibility of population-based spatio-temporal injury surveillance. Even over a relatively short period, the geographical distribution of where injuries occur may change, and different injuries present different spatio-temporal patterns. These findings have implications for health policy and service delivery.
LEVEL OF EVIDENCE Epidemiologic study, level V.
Methods: Retrospective analysis of five years’ (2009-2013) of trauma incident location data. We analysed the study population as a whole, as well as predefined subgroups, such as those with abnormal physiological signs. In order to leverage sufficient statistical power to detect temporal trends in rare events over short time periods and small spatial units, we used a geographically weighted regression model.
Results: There were 509,725 incidents. There were increases in case volume in Glasgow, the central Southern part of the country, the Northern parts of the Highlands, the North-East, and the Orkney and Shetland Islands. Statistically significant changes were mostly restricted to major cities. Decreases in the number of incidents were seen in the Hebrides, Western Scotland, Fife and Lothian, and the Borders. Statistically significant changes were seen mostly in Fife and Lothian, the West, some areas of the Borders, and in the Peterhead area. Subgroup analyses showed markedly different spatio-temporal patterns.
Conclusions: This project has demonstrated the feasibility of population-based spatio-temporal injury surveillance. Even over a relatively short period, the geographical distribution of where injuries occur may change, and different injuries present different spatio-temporal patterns. These findings have implications for health policy and service delivery.
LEVEL OF EVIDENCE Epidemiologic study, level V.
| Original language | English |
|---|---|
| Pages (from-to) | 289-298 |
| Number of pages | 10 |
| Journal | The journal of trauma and acute care surgery |
| Volume | 86 |
| Issue number | 2 |
| Early online date | 10 Dec 2018 |
| DOIs | |
| Publication status | Published - Feb 2019 |
| Event | 13th Annual Academic Surgical Congress (ASC) 2018 - Jacksonville, United States Duration: 30 Jan 2018 → 1 Feb 2018 |
Keywords
- trauma
- trauma systems
- geographical information systems
- geospatial analysis
- geographically weighted regression
- geographic information systems
- Trauma
Access to Document
- Accepted Manuscript
http://www.wkopenhealth.com/inst-fund.php https://creativecommons.org/licenses/by-nc/4.0/