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Acta Anaesthesiol Scand. 2019 May 9. doi: 10.1111/aas.13384. [Epub ahead of print]

Increased risk of fatal paediatric injuries in rural Northern Norway.

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Anaesthesia and Critical Care Research Group, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Hammerfest, Norway.
Department of Anaesthesia and Intensive Care, Hammerfest Hospital, Finnmark Health Trust, Hammerfest, Norway.
Norwegian National Advisory Unit on Trauma, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.



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.


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.


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.


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.


Norway; epidemiology; injury; paediatric; rural health; trauma


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