Clinical Analysis of the Cultivator-Related Trauma Patients Over 65 Years of Age in Rural Communities of Western Gyeongsang Southern Province

Jung, E J; Ha, W S; Choi, S G; Hong, S C; Lee, Y J; Jeong, C Y; Joo, Y T; Park, S T

Abstract

BACKGROUND
The number of old people has drastically increased in rural Korea, showing an increase of more than 20%. With the age of people using farm equipments on the rise, the number of cultivator-related injuries is also increasing due to inept driving, drunken driving, and traffic violation. Compared with young people, the seriousness of injuries by farm equipments is much higher in old people since the morbidity and mortality are high in these people who have many physical defects. Thus, the characteristics of old people who had received cultivator-related injuries were analyzed, centering around the injury mechanism, injured organs, hospital stay, mortality, injury severity score (ISS), complication, operation rate, and presence of previous chronic disease. Through this analysis, emergency measures in old people who received cultivator-related injuries and therapeutic approach were examined.
MATERIALS AND METHODS
The 114 patients who visited the emergency room at Gyeongsang University Hospital due to cultivator- related injuries from January 1999 to May 2002, were evaluated retrospectively. These 114 patients were divided into two age groups, ie., those older than 65-years of age and those younger than 65. Then, the analysis was made by comparing the gender, injured organ, operation rate, complications, involvement of alcohol at the time of accident, presence of chronic disease, hospital stay, ISS (injury severity score) and mortality.
RESULTS
1) Cultivator-related injuries were present in 42.1% of those patients older than 65-years of age in whom the mortality was 0.7%, which was significantly higher than that in the patients younger than 65-years of age(p<0.05). 2). The average hospital stay was significantly longer and ISS was significantly higher in those older than 65-years of age. 3) There were no significant differences in injured organs, injury mechanism, operation rate, presence of chronic disease, involvement of alcohol at the time of injury, number of injuries, and previous history of having been involved in cultivator-related injuries between the two groups. 4) Among 8 patients older than 65-years of age who had died, 6 died within 24 h of injury due mostly to handle-bar-related injuries. 5) The average ISS was 25.75 in those patients older than 65-years of age. This score was lower than that in those patients younger than 65-years of age but was not statistically significant.
CONCLUSION
Among those subjects who were involved in cultivator-related injuries, the mortality rate was significantly higher in those patients older than 65-years of age compared with those younger than 65-years of age. Thus, physicians should pay careful attention to older people through repeated physical examination and thorough evaluation. By recognizing many physical defects in older patients and the fact that most deaths occur within 24 h of injury, active intervention is needed not only at the time of initial emergency visit but also from the time of transporting the patient. In order to reduce deaths due to cultivator-related trauma, farmers should undergo regular safety lessons and be taught to check and maintain cultivators thoroughly and preventive measures such as improving the handle-bar structure and material are needed.