@article{ref1,
title="A needs assessment for regionalization of trauma care in a rural state",
journal="American surgeon",
year="2005",
author="Rogers, F. B. and Madsen, Lynn and Shackford, S. and Crookes, Bruce and Charash, William and Morrow, P. and Osler, Turner and Jawa, Randeep and Rebuck, Jill A. and Igneri, Peter",
volume="71",
number="8",
pages="690-693",
abstract="Systems of trauma care in urban areas have a demonstrated survival benefit. Little is known of the benefit of trauma system organization in rural areas. We hypothesized that examination of all trauma deaths during a 1-year period would provide opportunities to improve care in our rural state. We used a medical examiner database of trauma deaths occurring during a 1-year period. Five board-certified surgeons analyzed deaths as preventable (P), potentially preventable (PP), and nonpreventable (NP) using modified Delphi technique. There were 223 trauma deaths during a 1-year period. Most (63%) died at the scene prior to any medical intervention. Adjudication of the deaths demonstrated 5 P (2%; 95% CI 1-5%), 36 PP (16%; 95% CI 12-27%), and 179 NP (81%; 95% CI 76-86%). Agreement among trauma surgeons was only moderate with a k of 0.46. Suicide accounted for a significant number of the overall trauma deaths at 32 per cent. Rural trauma system design should focus on discovery, as that is where the majority of deaths occur. Suicide is a significant problem in this rural state that should be aggressively targeted with prevention programs.",
language="",
issn="0003-1348",
doi="",
url="http://dx.doi.org/"
}