Trauma on Farms in the Republic of Ireland.
Agricultural trauma
Emergency medical services
Emergency medicine
Farm trauma
Farming
Injury
Major trauma
Silver trauma
Trauma team
Workplace injury
Journal
Injury
ISSN: 1879-0267
Titre abrégé: Injury
Pays: Netherlands
ID NLM: 0226040
Informations de publication
Date de publication:
Sep 2020
Sep 2020
Historique:
received:
05
02
2020
revised:
27
04
2020
accepted:
01
05
2020
pubmed:
2
6
2020
medline:
20
5
2021
entrez:
2
6
2020
Statut:
ppublish
Résumé
Farming is the most dangerous occupation in high-income countries worldwide. However, there is a lack of descriptive literature in this area. Injuries on farms are increasing, at a time when the cohort of trauma patients generally has become older and more medically complex. Farmers continue to work late in life when other industry workers would be retired. This study describes major trauma occurring on farms in the Republic of Ireland, the demographics of patients and treatments they received. Data was gathered from the National Office of Clinical Audit Major Trauma Audit (MTA) 2014 to 2016. Patients were included and excluded based on Trauma Audit and Research Network(TARN) inclusion criteria. There were 430 patients included in this study. The median age was 54.5 years (range 1-93). There were 6.3%(n=27) paediatric patients, and 27%(n=116) over 65-year olds. Patients had predominantly low Charlson Comorbidity Index scores (median 0). Patients >65 years had more comorbidities (p<0.001). The median ISS was 9(IQR 9-17). The most common mechanism of injury was blow from animal (n=126,29%) followed by low fall (n=115,27%). Summer was the most common season of injury (n=128,30%) and most patients presented to a hospital between 8am-12am(n=412,96%). There were 11 patients (2.6%) who died after arrival to hospital - most commonly due to head injury (n=5,45%). The median length of stay was six days; older patients stayed longer than younger patients (6 vs 12 days,p<0.001). The most common body area injured was limbs (n=139,32%), followed by chest (n=89,21%), spine (n=67,16%) and head injuries (n=64,15%). There were 84 patients (19.5%) who underwent operative intervention, and 77(18%) required intensive care unit (ICU) admission. Farm trauma patients were more likely to arrive by helicopter than other MTA patients. A substantial proportion of trauma on Irish farms involves older men who have co-morbidities and complexity of medical need. Farm trauma occurs in rural and remote locations with longer journey times to trauma centres and trauma units-this has implications for trauma care education and mode of EMS transport. Older patients who suffer trauma on farms require longer hospital stays and may not return to independent living.
Sections du résumé
BACKGROUND
BACKGROUND
Farming is the most dangerous occupation in high-income countries worldwide. However, there is a lack of descriptive literature in this area. Injuries on farms are increasing, at a time when the cohort of trauma patients generally has become older and more medically complex. Farmers continue to work late in life when other industry workers would be retired. This study describes major trauma occurring on farms in the Republic of Ireland, the demographics of patients and treatments they received.
METHODS
METHODS
Data was gathered from the National Office of Clinical Audit Major Trauma Audit (MTA) 2014 to 2016. Patients were included and excluded based on Trauma Audit and Research Network(TARN) inclusion criteria.
RESULTS
RESULTS
There were 430 patients included in this study. The median age was 54.5 years (range 1-93). There were 6.3%(n=27) paediatric patients, and 27%(n=116) over 65-year olds. Patients had predominantly low Charlson Comorbidity Index scores (median 0). Patients >65 years had more comorbidities (p<0.001). The median ISS was 9(IQR 9-17). The most common mechanism of injury was blow from animal (n=126,29%) followed by low fall (n=115,27%). Summer was the most common season of injury (n=128,30%) and most patients presented to a hospital between 8am-12am(n=412,96%). There were 11 patients (2.6%) who died after arrival to hospital - most commonly due to head injury (n=5,45%). The median length of stay was six days; older patients stayed longer than younger patients (6 vs 12 days,p<0.001). The most common body area injured was limbs (n=139,32%), followed by chest (n=89,21%), spine (n=67,16%) and head injuries (n=64,15%). There were 84 patients (19.5%) who underwent operative intervention, and 77(18%) required intensive care unit (ICU) admission. Farm trauma patients were more likely to arrive by helicopter than other MTA patients.
CONCLUSIONS
CONCLUSIONS
A substantial proportion of trauma on Irish farms involves older men who have co-morbidities and complexity of medical need. Farm trauma occurs in rural and remote locations with longer journey times to trauma centres and trauma units-this has implications for trauma care education and mode of EMS transport. Older patients who suffer trauma on farms require longer hospital stays and may not return to independent living.
Identifiants
pubmed: 32475649
pii: S0020-1383(20)30403-4
doi: 10.1016/j.injury.2020.05.001
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2025-2032Informations de copyright
Copyright © 2020 Elsevier Ltd. All rights reserved.