Pediatric Trauma Mortality in Jerusalem’s Israeli Healthcare System: A Retrospective Analysis

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...

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Main Authors: Rebecca Brooks, Daniel Marcus, Hagay Stern, David Rekhtman, Saar Hashavya, Shaden Salameh, Giora Weiser, Uri Pollak, Jacques Braun, Itai Shavit
Format: Article
Language:English
Published: Springer 2025-03-01
Series:Journal of Epidemiology and Global Health
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Online Access:https://doi.org/10.1007/s44197-025-00391-0
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author Rebecca Brooks
Daniel Marcus
Hagay Stern
David Rekhtman
Saar Hashavya
Shaden Salameh
Giora Weiser
Uri Pollak
Jacques Braun
Itai Shavit
author_facet Rebecca Brooks
Daniel Marcus
Hagay Stern
David Rekhtman
Saar Hashavya
Shaden Salameh
Giora Weiser
Uri Pollak
Jacques Braun
Itai Shavit
author_sort Rebecca Brooks
collection DOAJ
description 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.
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spelling doaj-art-da0458ac24ee466fbb2d9faabdf98bbf2025-08-20T02:49:29ZengSpringerJournal of Epidemiology and Global Health2210-60142025-03-011511810.1007/s44197-025-00391-0Pediatric Trauma Mortality in Jerusalem’s Israeli Healthcare System: A Retrospective AnalysisRebecca Brooks0Daniel Marcus1Hagay Stern2David Rekhtman3Saar Hashavya4Shaden Salameh5Giora Weiser6Uri Pollak7Jacques Braun8Itai Shavit9Department of Pediatrics, Pediatric Intensive Care Unit, Hadassah Mount Scopus Medical CenterFaculty of Medicine, Hebrew University of JerusalemFaculty of Medicine, Hebrew University of JerusalemFaculty of Medicine, Hebrew University of JerusalemFaculty of Medicine, Hebrew University of JerusalemFaculty of Medicine, Hebrew University of JerusalemFaculty of Medicine, Hebrew University of JerusalemFaculty of Medicine, Hebrew University of JerusalemFaculty of Medicine, Hebrew University of JerusalemFaculty of Medicine, Hebrew University of JerusalemAbstract 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.https://doi.org/10.1007/s44197-025-00391-0TraumaMortalityChildrenEthnicity
spellingShingle Rebecca Brooks
Daniel Marcus
Hagay Stern
David Rekhtman
Saar Hashavya
Shaden Salameh
Giora Weiser
Uri Pollak
Jacques Braun
Itai Shavit
Pediatric Trauma Mortality in Jerusalem’s Israeli Healthcare System: A Retrospective Analysis
Journal of Epidemiology and Global Health
Trauma
Mortality
Children
Ethnicity
title Pediatric Trauma Mortality in Jerusalem’s Israeli Healthcare System: A Retrospective Analysis
title_full Pediatric Trauma Mortality in Jerusalem’s Israeli Healthcare System: A Retrospective Analysis
title_fullStr Pediatric Trauma Mortality in Jerusalem’s Israeli Healthcare System: A Retrospective Analysis
title_full_unstemmed Pediatric Trauma Mortality in Jerusalem’s Israeli Healthcare System: A Retrospective Analysis
title_short Pediatric Trauma Mortality in Jerusalem’s Israeli Healthcare System: A Retrospective Analysis
title_sort pediatric trauma mortality in jerusalem s israeli healthcare system a retrospective analysis
topic Trauma
Mortality
Children
Ethnicity
url https://doi.org/10.1007/s44197-025-00391-0
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