TDNet Discover

Background: Around 70% of adults in the U.S have experienced some type of physical or psychological traumatic event at least once in their lives. Current research compares traumatic patient outcomes in those who live in rural versus urban areas. However in these studies, the sample sizes are significantly smaller in rural areas compared to those in urban areas. With these sample sizes having a comparable difference, there comes into question whether or not these studies are accurately valid. Objective: To determine whether the difference in sample sizes in current literature comparing patient outcomes in rural versus urban trauma affects the validity of the results. Methods: An evidence-based medicine meta-analysis systematic literature review was completed during October 2020 through March 2021. Multiple search databases were utilized using specific search phrases to identify research already completed within the last 10 years, specifically in the United States. Articles that pertained to the current research in question went through a rigorous process involving quality assessments and data extractions to compare and contrast sample sizes. Results: Four of the original fourteen studies were utilized for data extraction on mortality studies due to trauma. Studies were grouped based on population and main outcome of interest in order to determine ideal sample size. The population sizes and odds ratios (OR) from each of the studies were used to determine the number of patients needed in each study to see a significant difference. A power level of 95% was determined based on a sample size calculation using the average OR and sample size. There was a 14% difference in mortality rates between urban and iv rural populations. Only 18% of the participants in the four included studies were from rural areas. Conclusion: Those who are involved in a traumatic medical event in rural settings are at a 14% higher chance of poorer outcomes than those in urban settings.