Evaluation of Trauma Registry Data for Tracking Agriculture-Related Injuries in Nebraska, 2014: A Novel Approach

Monday, June 20, 2016: 2:05 PM
Tubughnenq' 3, Dena'ina Convention Center
Ketki Patel , College of Public Health, University of Nebraska Medical Center, Omaha, NE
Derry Stover , Nebraska Department of Health and Human Services, Lincoln, NE
Risto Rautiainen , College of Public Health, University of Nebraska Medical Center, Omaha, NE
Thomas Safranek , Nebraska Department of Health and Human Services, Lincoln, NE
BACKGROUND: Agriculture is one of the highest mortality risk industries, but the dynamic nature of industry and its workforce makes agricultural injury surveillance activities challenging. We examined trauma registry data using unique case-identification criteria to identify agriculture-related injuries admitted to a designated trauma center in Nebraska. We also evaluated the injury outcomes for most commonly occurring agriculture-related injuries.  

METHODS: Traumatic agriculture-related injuries admitted, transferred or dead on arrival to a designated trauma center in 2014 were identified using the Nebraska trauma registry. This analysis included injuries to patients aged 16 years and older. The injuries were classified as- definite, probable and possible cases of agriculture-related injuries. Injuries with the work-related field “yes” or primary payer “workers compensation” and occupation or industry matching keywords “farm”, “ranch”, “agriculture” were defined as definite cases. If external cause of injury (E-code) location was “farm –E849.1” or primary E-code was “E919.0-accident caused by farm machinery” then it was a probable case. Possible cases included injuries with E-codes –“E827- animal drawn vehicle accident”, “E828-accident involving animal being ridden” and “E906.8-other specified injury caused by animal”. Case specific injury rates were calculated. Outcomes of agriculture-related injuries were evaluated based on the injury severity score, length of hospital stay and status at discharge.  

RESULTS: In Nebraska, there were 432 agriculture-related injuries requiring medical care in 2014; out of which 25 (5.8%) were definite, 315 (72.9%) were probable and 92 (21.3%) were possible cases. Preliminary analysis showed that majority of injuries were in: males (81%), age groups ≥65 (24%) and 55-64 (23%) and occurred during summer months June, July and August (31%). The most common diagnosis of injuries was fracture (17.5%). The majority of injuries were minor with an injury severity score <9 (60%) and required ≤7 days of hospital stay (56%). Most injured patients were discharged and sent home without any further treatment (59%); with exception of 3 (0.7%) fatalities.  

CONCLUSIONS: A three-tier case definition allowed us to capture traumatic agriculture-related injuries occurring on and off-farms. Comparison of injuries by patient demographics and evaluation of injury outcomes for most common injuries using surveillance data helps determine the priority areas for intervention. Next steps include assessment of co-morbidities in those sustaining traumatic agriculture-related injuries.