Experts from Johns Hopkins presented their latest research during the 2024 American Pediatric Surgical Association annual meeting. In this video, general surgery resident Matt Price discusses his team’s research on patterns of injury and reinjury among children living in Maryland, focusing specifically on rural versus urban patterns of reinjury.
Hello, I'm Matt Price. I am a general surgery resident at Johns Hopkins. I've been working closely with Doctor Isam Nasser, as well as Doctor Mark Slidell over the past year, specifically looking at patterns of injury and reinjury among Children living in the state of Maryland. Most recently, we presented our work at the American Pediatric Surgical Association where we presented on rural versus urban patterns of reinjury. What we used for this analysis was the Maryland Health Services cost review commission data set, which is a really robust data set that allows us to track patients regardless of which health care system they present to as long as it's within the state of Maryland. And what we were looking at was reinjury, which we define as a repeat presentation to emer an emergency department with a new traumatic injury. Within one year of their initial injury. We perform multi variable as well as multilevel analyses. Specifically adjusting for demographics, injury severity mechanism and intent of injury. We had hypothesized that Children living in urban settings would have a higher risk for reinjury. But what we ended up finding was it was actually Children living in rural settings had a higher risk of reinjury. On our multilevel model. Specifically looking at this figure here, we're looking at the adjusted relative risk of reinjury stratified by county population density. Each dot here represents a specific county within the state of Maryland. The red line is the state's average risk for injury. And the blue line is the division of rural versus urban counties as designated by the Mary annotated code of Maryland. What we see is rural counties tend to have a higher risk of reinjury compared to urban counties. When we're looking at the six urban counties over on the right side, we see that there's only one county with a higher risk of reinjury. And then that county is specifically Baltimore City. When we redo this in analysis, looking at major reinjury, which we define as requiring an inpatient admission after, after suffering a traumatic injury, we end up not seeing this difference between rural and urban counties. What this suggests is the difference that we're seeing in rural versus urban reinjury is largely related to minor re injuries in rural settings. There's further work that we need to do on this to identify the specific risk factors when it comes to developing prevention and intervention efforts. Um But I've been grateful to work on this project with Doctor Slidell, as well as Doctor Nasser, um as and the rest of the research team. Uh I'm grateful for the Johns Hopkins Surgery Center for Outcomes Research who helped us gain access to this data set and have been very supportive throughout this project. Thank you.
