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More than 50% of injury-related deaths in rural Ontario occur before patients reach hospital

Even when seriously injured people make it to hospital, the risk is high that they will die in the Emergency Department

Toronto, January 26, 2010

It’s known that people who live or work in rural areas are more likely to suffer and die from serious injuries compared to those in more urban environments. But while time and distance play a role in these higher mortality rates, new research suggests that limited access to early, high-quality trauma care in many smaller Ontario hospitals may be a factor.

Researchers from St. Michael’s in Toronto looked at 3,486 trauma-related deaths that occurred in Ontario between 2002 and 2003, which was the most recent data available for analysis. (A traumatic injury is caused by something outside the person's body—for example, a leg crushed by machinery or a head injury caused by a fall from a ladder.)

“We wanted to see what happened to these patients after they were injured and also to learn more about the settings in which death was most likely to occur,” explains study investigator Dr. Avery B. Nathens, director of trauma services at St. Michael’s and Canada Research Chair in Systems of Trauma Care.

The study found that more than half of the deaths occurred before the injured person reached a hospital emergency department (ED). These “pre-hospital” deaths were twice as likely among patients injured in the most rural locations and in those with limited access to timely trauma centre care.

St. Michael’s is partnering with the Ontario Telemedicine network to evaluate the usefulness of telemedicine in helping community hospitals deliver better early care to severely injured patients.