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An analysis of the relationship between location of residence and location of injury

Haas, Barbara MD, PhD; Doumouras, Aristithes G. MD; Gomez, David MD, PhD; de Mestral, Charles MD, PhD; Boyes, Donald M. PhD; Morrison, Laurie MD, MSc; Nathens, Avery B. MD, PhD

Journal of Trauma and Acute Care Surgery: April 2015 - Volume 78 - Issue 4 - p 860–865
doi: 10.1097/TA.0000000000000595
Original Articles

BACKGROUND Injury surveillance is critical in identifying the need for targeted prevention initiatives. Understanding the geographic distribution of injuries facilitates matching prevention programs with the population most likely to benefit. At the population level, however, the geographic site of injury is rarely known, leading to the use of location of residence as a surrogate. To determine the accuracy of this approach, we evaluated the relationship between the site of injury and of residence over a large geographic area.

METHODS Data were derived from a population-based, prehospital registry of persons meeting triage criteria for major trauma. Patients dying at the scene or transported to the hospital were included. Distance between locations of residence and of injury was calculated using geographic information system network analysis.

RESULTS Among 3,280 patients (2005–2010), 88% were injured within 10 miles of home (median, 0.2 miles). There were significant differences in distance between residence and location of injury based on mechanism of injury, age, and hospital disposition. The large majority of injuries involving children, the elderly, pedestrians, cyclists, falls, and assaults occurred less than 10 miles from the patient’s residence. Only 77% of motor vehicle collision occurred within 10 miles of the patient’s residence.

CONCLUSION Although the majority of patients are injured less than 10 miles from their residence, the probability of injury occurring “close to home” depends on patient and injury characteristics.

LEVEL OF EVIDENCE Epidemiologic study, level III.

From the Interdepartmental Division of Critical Care (B.H.), Division of General Surgery, Department of Surgery (D.G., C.D.M., A.B.N.), Department of Geography and Planning (D.M.B.), and Division of Emergency Medicine, Department of Medicine (L.M.), University of Toronto; Sunnybrook Research Institute (B.H. D.G., C.D.M., A.B.N.); Li Ka Shing Knowledge Institute of St Michael’s Hospital(L.M.), Toronto; and Division of General Surgery, Department of Surgery (A.G.D.), McMaster University, Hamilton, Ontario, Canada.

Submitted: October 16, 2014, Revised: December 22, 2014, Accepted: December 23, 2014.

The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the National Heart, Lung and Blood Institute or the National Institutes of Health. The opinions, results, and conclusions reported in this article are those of the authors and are independent from the funding sources.

Address for reprints: Barbara Haas, 2075 Bayview Ave, Suite D574, Toronto, ON, Canada, M4N 3 M5; email:

© 2015 Lippincott Williams & Wilkins, Inc.