Swanton Amanda R, Young Tracy L, Leinenkugel Kathy, Torner James C, Peek-Asa Corinne
Injury Prevention Research Center, University of Iowa, 2190 WL (Westlawn), Iowa City, IA 52242, USA; Carver College of Medicine, University of Iowa, 375 Newton Road, Iowa City, IA 52242, USA.
Injury Prevention Research Center, University of Iowa, 2190 WL (Westlawn), Iowa City, IA 52242, USA.
J Safety Res. 2015 Jun;53:97-102. doi: 10.1016/j.jsr.2015.03.002. Epub 2015 Mar 20.
To identify tractor-related injuries using data from a statewide trauma system, to characterize the mechanisms of nonfatal tractor-related injury, and to determine which injuries are associated with higher severity injury.
A retrospective observational study was conducted using the Iowa State Trauma Registry to identify cases of nonfatal tractor-related injuries over an 11-year period from 2002 to 2012. Frequency of injury was reported by age, sex, severity, and nature. Injuries were classified by mechanism and a polytomous regression model was used to predict injury severity adjusting for sex and age.
Five-hundred thirteen nonfatal tractor-related injuries were identified with 18% classified as severe. Injuries were most frequent among males and among those ≥45years of age. Rollovers were the most frequent mechanism of both total (25%) and severe injury (38%), although the frequency of injury mechanism varied by age. Falls were the next most frequent mechanism of injury (20%) but resulted in fewer high-severity injuries. Collision (adjOR=1.89, 95% CI=1.01-3.51), rollover (adjOR=2.03, 95% CI=1.21-3.40), and run over/rolled on (adjOR=2.06, 95% CI=1.17-3.62) injuries were significantly associated with higher injury severity. Advanced age was also a significant predictor of higher severity injury (adjOR=1.82, 95% CI=1.06-3.12).
Mechanisms of nonfatal tractor-related injuries are heterogeneous, differ by age, and are associated with varying level of severity.
This work shows the burden of nonfatal tractor injuries on a rural state trauma system. These findings also demonstrate the heterogeneous nature of nonfatal tractor injuries and underscore the need for a multi-level approaches to injury prevention.
利用全州创伤系统的数据识别与拖拉机相关的损伤，描述非致命性拖拉机相关损伤的机制，并确定哪些损伤与更严重的损伤相关。
采用回顾性观察研究，利用爱荷华州创伤登记处的数据，识别2002年至2012年11年间非致命性拖拉机相关损伤的病例。按年龄、性别、严重程度和性质报告损伤频率。根据损伤机制对损伤进行分类，并使用多分类回归模型预测调整性别和年龄后的损伤严重程度。
共识别出513例非致命性拖拉机相关损伤，其中18%被归类为严重损伤。损伤在男性和45岁及以上人群中最为常见。翻车是总体损伤（25%）和严重损伤（38%）最常见的机制，尽管损伤机制的频率因年龄而异。跌倒次之，是第二常见的损伤机制（20%），但导致的高严重度损伤较少。碰撞（调整后比值比=1.89，95%置信区间=1.01-3.51）、翻车（调整后比值比=2.03，95%置信区间=1.21-3.40）以及碾压/被碾压（调整后比值比=2.06，95%置信区间=1.17-3.62）损伤与更高的损伤严重程度显著相关。高龄也是更高严重度损伤的显著预测因素（调整后比值比=1.82，95%置信区间=1.06-3.12）。
非致命性拖拉机相关损伤的机制具有异质性，因年龄而异，且与不同程度的严重度相关。
这项工作显示了农村州创伤系统中非致命性拖拉机损伤的负担。这些发现还证明了非致命性拖拉机损伤的异质性，并强调了采取多层次预防损伤方法的必要性。
