Rebecca Brooks, Daniel Marcus, Hagay Stern, David Rekhtman, Saar Hashavya, Shaden Salameh, Giora Weiser, Uri Pollak, Jacques Braun, Itai Shavit
{"title":"Pediatric Trauma Mortality in Jerusalem's Israeli Healthcare System: A Retrospective Analysis.","authors":"Rebecca Brooks, Daniel Marcus, Hagay Stern, David Rekhtman, Saar Hashavya, Shaden Salameh, Giora Weiser, Uri Pollak, Jacques Braun, Itai Shavit","doi":"10.1007/s44197-025-00391-0","DOIUrl":null,"url":null,"abstract":"<p><p>Jerusalem's intricate geopolitical environment, ethnic diversity, and divided healthcare systems between its East and West regions may impact pediatric trauma mortality. This study investigated pediatric trauma mortality rates in Jerusalem's Israeli healthcare system. We conducted a retrospective cohort study on Jerusalem residents under 18 who died from trauma in the Emergency Department (ED) or within a week of hospital admission (ED/7-day) between January 2013, and December 2023. Jerusalem's overall population data were obtained from the Israel Central Bureau of Statistics. During the study period, 121 pediatric trauma patients had ED/7-day death, 82 were Jerusalem residents. The annual mortality incidence among the city population was 2.1/100,000. Twenty-three children were Jews and 59 were East Jerusalem Arabs. The trauma mortality Incidence Rate Ratio for Arab versus Jewish children was 3.6 (95% CI 2.2-5.9). Death was declared upon ED arrival or within one hour in 52% (95% CI 30.6-73.1%) and 64% (95% CI 50.9-76.4%) of the Jewish and Arab children, respectively. In 2/23 [8.7% (95% CI 1.0-28.0%)] Jews, and 2/59 [3.4% (95% CI 0.4-11.7%)] Arabs, death occurred due to an injury related to the Israeli-Palestinian conflict. In 13/59 [22% (95% CI 12.3-34.7%)] of the Arabs, resuscitation was initiated in a community clinic before the arrival of Emergency Medical Services (EMS), and in 5/59 [8.5% (95% CI 2.8-18.7%)] the child was brought to the hospital by caregivers rather than by EMS. This study provides evidence that Jerusalem's child trauma death rate in Jerusalem's Israeli healthcare system is comparable to high-income European countries. However, East Jerusalem Arab children are more vulnerable to trauma-related deaths than Jewish children. These results provide a basis for targeted trauma prevention programs.</p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":"15 1","pages":"49"},"PeriodicalIF":3.8000,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11937459/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Epidemiology and Global Health","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s44197-025-00391-0","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
引用次数: 0
Abstract
Jerusalem's intricate geopolitical environment, ethnic diversity, and divided healthcare systems between its East and West regions may impact pediatric trauma mortality. This study investigated pediatric trauma mortality rates in Jerusalem's Israeli healthcare system. We conducted a retrospective cohort study on Jerusalem residents under 18 who died from trauma in the Emergency Department (ED) or within a week of hospital admission (ED/7-day) between January 2013, and December 2023. Jerusalem's overall population data were obtained from the Israel Central Bureau of Statistics. During the study period, 121 pediatric trauma patients had ED/7-day death, 82 were Jerusalem residents. The annual mortality incidence among the city population was 2.1/100,000. Twenty-three children were Jews and 59 were East Jerusalem Arabs. The trauma mortality Incidence Rate Ratio for Arab versus Jewish children was 3.6 (95% CI 2.2-5.9). Death was declared upon ED arrival or within one hour in 52% (95% CI 30.6-73.1%) and 64% (95% CI 50.9-76.4%) of the Jewish and Arab children, respectively. In 2/23 [8.7% (95% CI 1.0-28.0%)] Jews, and 2/59 [3.4% (95% CI 0.4-11.7%)] Arabs, death occurred due to an injury related to the Israeli-Palestinian conflict. In 13/59 [22% (95% CI 12.3-34.7%)] of the Arabs, resuscitation was initiated in a community clinic before the arrival of Emergency Medical Services (EMS), and in 5/59 [8.5% (95% CI 2.8-18.7%)] the child was brought to the hospital by caregivers rather than by EMS. This study provides evidence that Jerusalem's child trauma death rate in Jerusalem's Israeli healthcare system is comparable to high-income European countries. However, East Jerusalem Arab children are more vulnerable to trauma-related deaths than Jewish children. These results provide a basis for targeted trauma prevention programs.
耶路撒冷复杂的地缘政治环境、种族多样性以及东西方地区医疗体系的分裂可能会影响儿科创伤死亡率。本研究调查了耶路撒冷以色列医疗保健系统的儿科创伤死亡率。我们对2013年1月至2023年12月期间在急诊科(ED)或入院一周内(ED/7天)因创伤死亡的18岁以下耶路撒冷居民进行了回顾性队列研究。耶路撒冷的全部人口数据来自以色列中央统计局。在研究期间,121名儿童创伤患者发生ED/7天死亡,其中82名是耶路撒冷居民。城市人口年死亡率为2.1/10万。23名儿童是犹太人,59名是东耶路撒冷阿拉伯人。阿拉伯儿童与犹太儿童的创伤死亡率比为3.6 (95% CI 2.2-5.9)。犹太裔儿童和阿拉伯裔儿童分别有52% (95% CI 30.6-73.1%)和64% (95% CI 50.9-76.4%)在ED到达后或1小时内宣布死亡。在2/23 [8.7% (95% CI 1.0-28.0%)]犹太人和2/59 [3.4% (95% CI 0.4-11.7%)]阿拉伯人中,死亡是由于与以色列-巴勒斯坦冲突有关的伤害造成的。13/59 [22% (95% CI 12.3-34.7%)]的阿拉伯人在紧急医疗服务(EMS)到达之前在社区诊所进行了复苏,5/59 [8.5% (95% CI 2.8-18.7%)]的儿童是由护理人员而不是EMS带到医院的。这项研究提供的证据表明,耶路撒冷的儿童创伤死亡率在耶路撒冷的以色列医疗保健系统是相当高收入的欧洲国家。然而,东耶路撒冷阿拉伯儿童比犹太儿童更容易遭受与创伤有关的死亡。这些结果为有针对性的创伤预防项目提供了基础。
期刊介绍:
The Journal of Epidemiology and Global Health is an esteemed international publication, offering a platform for peer-reviewed articles that drive advancements in global epidemiology and international health. Our mission is to shape global health policy by showcasing cutting-edge scholarship and innovative strategies.