J Korean Soc Emerg Med.  2011 Dec;22(6):615-622.

Analysis of Factors Influencing the Severity of Cultivator-Related Trauma patients and Correlation between these Factors

• Oh JH
• Lee HY
• Lee BK
• Ryu HH
• Jeung KW
• Heo T
• Min YI

Abstract

PURPOSE
Rural areas of Korea are already aged societies, and the victims of trauma in these areas are increasingly associated with an elderly demographic and farm equipment use. In addition, rural medical services are often not well supported. The purpose of this study was to evaluate the factors that influence the severity and prognosis of cultivator-related trauma, and the correlations between these factors.
METHODS
We retrospectively analyzed patients who visited the Chonnam National University Hospital emergence center due to cultivator-related trauma, from January 2006 to December 2010. The injury severity of these patients was analyzed according to the injury severity score (ISS), the revised trauma score (RTS), the new injury severity score (NISS) and the trauma score and injury severity score (TRISS).
RESULTS
A total of 376 cases, 322 male and 54 female, of cultivator-related trauma were reviewed. Patient ages ranged from 25 to 85 years (median, 57 years). Patients were divided into two age groups, those older than 65-years of age and those younger than 65. The primary causes of traumatic injury were falling down (57.2%), and vehicle overturning (16.5%). The site most frequently injured was the chest (35.1%). Rate of acute complication was 29.8% and operation was required in 41% of cases. The average ISS was 9.0 (median range [quartile], 4-16). ISS, NISS, RTS and TRISS were statistically correlated with the mechanism of injury, site of injury, and mortality and complication rates. In particular, TRISS was significantly lower in cultivator-related trauma for those older than 65-years of age.
CONCLUSION
Among the severity indexes in assessing cultivator-related trauma, TRISS is helpful in assigning severity and predictable index in older, rural patients. However, this result is not representative of all possible cultivator-related traumas. A new statistical model is necessary to accurately analyze the severity and mortality in cases of cultivator-related trauma.

Keyword

Cultivator-related trauma; Rural area; Trauma score; Trauma and injury severity score

MeSH Terms

Aged
Female
Humans
Injury Severity Score
Korea
Male
Models, Statistical
Prognosis
Retrospective Studies
Thorax