The need for a statewide pediatric trauma program.

Development and maintenance of an effective regional trauma care system mandates on-going assessment of those at risk, patterns of injury and types of resources available. It is known that a significantly higher injury and traumatic death rates exists for children in a rural environment, and there is also evidence to support improved outcomes for children treated at verified trauma centers. While many still rely on practice-based statistics, we postulated that population-based statistics are much more reflective as to what is actually happening and provide crucial information on how improvements can be achieved. To test this theory, we reviewed all pediatric traumatic deaths for children 18 years old and younger from Jan. 1, 1990 to Dec. 31, 1998 at the Jon Michael Moore Trauma Center at West Virginia University, a rural pediatric trauma center. We compared this data to trauma mortality within the center's 13 county primary region from the Office of Vital Statistics. Our research revealed that mortality from pediatric trauma is higher in rural environments than in urban environments, and that population-based statistics more accurately reflect the true impact of what is actually happening in any given region. Age appears to be an important factor in determining which children are transferred to the trauma center and this may represent a critical factor in outcome.