Changing Patterns in Midwestern Farm Trauma: A Retrospective Comparative Analysis

Am Surg. 2022 Aug;88(8):1792-1797. doi: 10.1177/00031348221083949. Epub 2022 Apr 7.

Abstract

Objectives: The objective is to determine if injury patterns on agricultural workplaces have changed over time.

Methods: Retrospective chart review of farm trauma in Fargo, ND, from 2006 to 2020. Results were compared to historical results from La Crosse, WI, from 1978 to 1983. Patient charts with ICD location and external cause code relating to "farm" were included in the study. Frequencies and relative percentages were computed for each categorical variable. Chi-square tests were performed to determine which categories were significantly different from one another.

Results: Injuries on farms from 395 patients from 2006 to 2020 were compared to injuries from 375 patients from 1978 to 1983. Average age of patients in 2006-2020 was 48 compared to 36 for 1978-1983. There were fewer ISS 1-9, more ISS 10-24, and similar ISS > 25 from 2006 to 2020 compared to 1978-1983. Falls doubled in 2006-2020, 132 compared to 67 in 1978-1983. Injuries from tractors were fewer in 2006-2020, and 63 compared to 89 in 1978-1983. Neurological injuries almost doubled in 2006-2020 compared to 1978-1883, 126 and 61, respectively. All the aforementioned temporal differences were statistically significant with P value < .0001. There were 9 deaths from 2006 to 2020 and 8 deaths from 1978 to 1983.

Conclusion: Injuries on farms today occur in older patients with higher injury severity scores and are more likely to have neurological injuries compared to data from 1978 to 1983. These changing patterns in injuries can help to provide education, direct farm safety programs, and help triage resources to critical access hospitals that care for this patient population.

Keywords: agriculture; farm; trauma.

MeSH terms

  • Aged
  • Agriculture*
  • Farms
  • Humans
  • Injury Severity Score
  • Retrospective Studies
  • Wounds and Injuries* / epidemiology