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.
