Increased risk of fatal paediatric injuries in rural Northern Norway

Abstract

Background: Finnmark, Northern Norway, had a mortality rate for paediatric injury in 1998-2007 that was more than twice the national average. We investigated whether this rate had decreased in 2008-2015 after improvements in emergency care. We also compared the mortality rate to rates of non-fatal injury and trauma team activation both regionally and in Norway. Methods: The study was based on 4 national registries. Mortality and injury rates were calculated per 100 000 persons per year. The study population was divided into age groups; 0-5, 6-10, 11-15 and 16-17 years. Results: Between 1998-2007 and 2008-2015 there was an overall decrease in paediatric mortality rate due to external causes in Norway in total from 7.1 to 4.0. Despite this, in 2008-2015, the mortality rate remained 2.5 times higher in Finnmark than in Norway (9.7, RR = 2.5 CI 1.4-4.3, P = 0.001), similar to findings for 1998-2007. Finnmark had half the rate of non-fatal injuries in 1999-2007 (5052, RR = 0.6, 95% CI 0.6-0.7, P < 0.001) and in 2008-2015 (3893, RR = 0.5, 95% CI 0.5-0.6, P < 0.001) as in Norway. The rate of trauma team activation was similar in Finnmark and Norway. Conclusions: The risk of injury-related death remained significantly higher, while the overall risk of non-fatal injury was significantly reduced for children in rural Northern Norway. Thus, injuries in this rural area seem to be less frequent but more severe. There is a need for detailed examination of each death to determine possible preventive measures.