Comparison of Traffic Accident Characteristics in Urban and Rural Settings: A Retrospective Study of Prehospital Emergency Data

Introduction: This study aimed to compare the epidemiological and clinical characteristics of traffic accidents in urban and rural areas using prehospital emergency data. Methods: This retrospective case series analyzed electronic records of traffic accident victims who were attended by prehospital emergency services in East Azerbaijan Province, Iran, from December 2024 to May 2025. All eligible cases registered in the Asayar integrated information system during the study period were included in the analysis using census sampling (N=9591). Data on demographic variables, temporal indicators, and clinical parameters were extracted. Statistical analysis was performed using SPSS version 26. Results: Response time was significantly longer in rural areas compared to urban areas (12.92 vs. 9.13 minutes, P<0.001). Light vehicles predominated in rural accidents (84.5%), whereas motorcycles accounted for the largest share in urban accidents (38.8%) (P<0.001). The clinical condition of victims was significantly worse in rural accidents, with a higher proportion of severe Glasgow Coma Scale scores (3.6% vs. 1.3%, P<0.001) and a greater percentage of low peripheral oxygen saturation (SpO₂<95%; 8.6% vs. 4.6%, P<0.001). Conclusion: Rural traffic accidents are associated with more severe injuries, worse physiological status, and longer prehospital response times. These findings underscore the urgent need for targeted improvements in prehospital emergency services for rural road networks.