A model for spatio-temporal injury surveillance: implications for the evolution of a trauma system

Jan O Jansen (Corresponding Author), Phil Emerson, Jonathan J Morrison, Thomas Cornulier

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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.
Original languageEnglish
Pages (from-to)289-298
Number of pages10
JournalThe journal of trauma and acute care surgery
Volume86
Issue number2
Early online date10 Dec 2018
DOIs
Publication statusPublished - Feb 2019
Event13th Annual Academic Surgical Congress (ASC) 2018 - Jacksonville, United States
Duration: 30 Jan 20181 Feb 2018

Keywords

  • trauma
  • trauma systems
  • geographical information systems
  • geospatial analysis
  • geographically weighted regression
  • geographic information systems
  • Trauma

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Surgery

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