Traktör Kazasına Bağlı Yaralanmaların Analizi: On Yıllık Retrospektif Çalışma

Abstract

Amaç: Traktörler, güvenlik donanımı bakımından diğer araçlara göre çok daha yetersiz olsa da tarımsal faaliyetlerin yanı sıra insan taşımacılığı için de sıkça kullanılır. Bu çalışmada, traktör kazası nedeniyle acil servise başvuran hastalar incelenmiştir. Gereç ve Yöntemler: On yıllık dönem içerisinde gerçekleşen traktör kazaları retrospektif olarak incelendi. Kazazedelerin demografik verileri, kazanın oluş mekanizması, travma skorları (Glasgow Koma Skoru, Injury Severity Score, Revize Travma Skoru, Pediatrik Travma Skoru), anatomik yaralanma bölgeleri, görüntüleme sonuçları ve klinik sonlanımları kaydedildi. Bulgular: Çalışmaya 165 hasta dahil edildi. Bunların yaş ortalaması 46.48±23.24/yıl, %82.4’ü erkek ve %41.8’i şofördü. En sık izlenen kaza mekanizması “traktörden düşme” idi. Toraks, en fazla yaralanan anatomik bölgeydi. Şoförlerde kafa ve toraks yaralanması oranı, yolculardan anlamlı olarak daha fazlaydı (Sırasıyla p=0.005; p=0.039). Kaza sonrası kazazede- lerin %3.6’sı eksitus oldu. Eksitus olanlardaki batın ve pelvis yaralanması oranı, yaşayanlardan anlamlı olarak daha fazlaydı (Sırasıyla p=0.018; p=0.015). Eksitus olanların Glasgow Koma Skoru ve Revize Travma Skoru düzeyi yaşayanlardan anlamlı olarak daha düşük (Sırasıyla p<0.001; p=0.001); Injury Severity Score düzeyi ise anlamlı olarak daha yüksekti (p<0.001). Mortalite ile batın ve pelvis yaralanması arasında pozitif korelasyon olduğu saptandı (Sırasıyla r=0.184, p=0.018; r=0.189, p=0.015). Sonuç: Çalışmamızın sonuçlarına göre, traktör kazaları sıklıkla orta yaş erkeklerde izlenmekte olup, toraks en fazla yaralanan bölgedir. Ölen kazazedeler daha fazla travma enerjisine maruz kalmış ve mortalitenin batın ve pelvis yaralanmasıyla ilişkili olduğu saptanmıştır.

Keywords

• Acil servis
• traktör kazası
• travma

Supporting Institution

Yoktur.

Project Number

None.

Ethical Statement

Kırıkkale Üniversitesi Girişimsel Olmayan Araştırmalar Etik Kurulu onayı alınmıştır (Tarih: 21.10.2021, sayı:2021/15, karar no:2021.10.11)

Thanks

Yoktur.

AN ANALYSIS OF INJURIES DUE TO TRACTOR ACCIDENTS: A TEN YEAR RETROSPECTIVE STUDY

Abstract

Objective: Although tractors are highly inadequate in terms of safety equipment compared to other vehicles, they are still frequently employed for agricultural activities and even human transportation. This study investigated patients presenting to the emergency department (ED) due to tractor accidents. Material and Methods: Tractor accidents occurring over a ten year period were examined retrospectively. Victims’ demographic data, the cause of the accident, trauma scores (Glasgow Coma Score, Injury Severity Score, Revised Trauma Score and Pediatric Trauma Score), injury localizations, imaging results, and clinical outcomes were recorded. Results: One hundred sixty-five patients were included. Their mean age was 46.48±23.24 years, 82.4% were men, and 41.8% were tractor drivers. The most frequent cause of accidents was “falling from the tractor”. The thorax was the most frequently injured anatomical region. Rates of head and thoracic injury were significantly higher in drivers compared to passengers (p=0.005 and p=0.039, respectively). The post-accident exitus rate was 3.6%. The incidence of abdominal and pelvic injuries was significantly higher in the exitus group than in the survivors (p=0.018 and p=0.015, respectively). Glasgow Coma Score and Revised Trauma Score levels were significantly lower in the exitus group than in the survivors (p<0.001 and p=0.001, respectively), while Injury Severity Score levels were significantly higher (p<0.001). Positive correlation was determined between mortality and abdominal and pelvic injury (r=0.184, p=0.018 and r=0.189, p=0.015, respectively). Conclusion: Based on our study findings, tractor accidents frequently seen involve middle-aged men, and the thorax is the most commonly injured region. Exitus victims were exposed to greater trauma energy, and mortality was correlated with abdominal and pelvic injury.

Keywords

• Emergency department
• tractor accident
• trauma

Supporting Institution

None.

Project Number

None.

Ethical Statement

Kırıkkale University Non-invasive Research Ethics Committee approval was received (Date: 21.10.2021, number: 2021/15, decision no: 2021.10.11)

Thanks

None.

References

1. Turkish Statistics Institute, “Road Traffic Accident Statistics 2017”. http://www.tuik.gov.tr/PreHaberBultenleri. (Accessed date: 09 February 2022)
2. Sanderson WT, Madsen MD, Rautiainen R, Kelly KM, Zwerling C, Taylor CD, et al. Tractor overturn concerns in Iowa: perspectives from the Keokuk county rural health study. J Agric Saf Health. 2006;12(1):71-81.
3. Pickett W, Hartling L, Brison RJ, Guernsey JR. Fatal work-related farm injuries in Canada, 1991-1995. CMAJ. 1999;160(13):1843-8.
4. Özkan A, Dilay Y, Mehmetbey K. Evaluation of Some Accidents in the Agriculture Sector from the Perspective of Occupational Safety. ISBN:978-605- 80320-3-3. UMYOS’19. 2019;3;40.
5. Öz E. Evaluation of the tractor accidents in Aegean Region from the point of farm safety. J Ege Univ Faculty of Agriculture. 2005;42(2):191-202.
6. https://www.slideshare.net/cerrahiklinik/20111017- travma-skor-sistemleri-26021543 (Accessed date: 11 October 2023)
7. Swanton AR, Young TL, Leinenkugel K, Torner JC, Peek-Asa C. Nonfatal tractor-related injuries presenting to a state trauma system. J Safety Res. 2015;53:97-102.
8. Vryhof D, Ouellette L, Chassee T, Singh M, Jones J. Life on the farm: A community-based study of tractor-related injuries and fatalities. Am J Emerg Med. 2019;37(7):1379-80.

9. Karbeyaz K, Şimşek Ü, Yilmaz A. Deaths related to tractor accidents in Eskişehir, Turkey: A 25‐year analysis. J Forensic Sci. 2019;64(6):1731-4.
10. Türkoglu A, Sehlikoglu K, Tokdemir M. Analysis of tractor-associated fatalities. Am J Forensic Med Pathol. 2017;38(4):306-11.
11. Goodman RA, Smith JD, Sikes RK, Rogers DL, Mickey JL. Fatalities associated with farm tractor injuries: An epidemiologic study. Public Health Rep. 1985;100(3):329-33.
12. Centers for Disease Control and Prevention (CDC). Farm-tractor-related fatalities-Kentucky, 1994. MMWR-Morb Mortal Wkly Rep. 1995;44(26):481- 4.
13. Erkol Z, Buken B, Hekimoglu Y, Erkol H, Ince H, Erzengin OU. Analysis of tractor-related deaths. J Agromedicine. 2013;18(2):87-97.
14. Moreschi C, Da Broi U, Cividino SRS, Gubiani R, Pergher G, Vello M, et al. The analysis of the cause- effect relation between tractor overturns and traumatic lesions suffered by drivers and passengers: A crucial step in the reconstruction of accident dynamics and the improvement of prevention. Agriculture. 2017;7(12):97.
15. https://www.englishlloyd.com/blog/2021/03/comm on-types-of-tractor-accidents/ (Accessed date: 11 October 2023)
16. https://www.hse.gov.uk/agriculture/topics/machiner y/farm-vehicles-2.htm (Accessed date: 11 October 2023)
17. Kim B, Lim S, Shin SY, Yum S, Kim YY, Yun N, et al. Risk assessment of tractor-related hazards based on accident cases. J Agric Saf Health. 2019;25(3):133-52.
18. Fulcher J, Noller A, Kay D. Farming tractor fatalities in Virginia: An 11-year retrospective review. Am J Forensic Med Pathol. 2012;33(4):377- 81.
19. Antunes SM, Cordeiro C, Teixeira HM. Analysis of fatal accidents with tractors in the centre of Portugal: Ten years analysis. Forensic Sci Int. 2018;287:74- 80.
20. Knight B. Transportation injuries. Kn Forensic Pathol. 2004:281-300.
21. Hell W, Langwieder K, Sporner A. Injury patterns compared to injury costs in car to car accidents of belted occupants with major injuries. Annu Proc Assoc Adv Automot Med. 1999;43:119-38.
22. Breen JM, Næss PA, Gaarder C, Stray-Pedersen A. Autopsy findings in drivers and passengers from fatal motor vehicle collisions: Limited differences in injury patterns and toxicological test results. Forensic Sci Med Pathol. 2021;17(2):235-46.
23. Sheehan M, Brent L, Deasy C. Trauma on farms in the Republic of Ireland. Injury. 2020;51(9):2025-32.
24. Franklin RC, Mitchell RJ, Driscoll TR, Fragar LJ. Agricultural work–related fatalities in Australia, 1989-1992. J Agric Saf Health. 2001;7(4):213-27.
25. Hösükler E, Hösükler B, Koç S. Tractor Related Deaths (Rollover, Fall, Accident, Lightning Strike). J Kırıkkale Univ Faculty Med. 2022;24(2):262-71.
26. ATLS Advanced Trauma Life Support 10th Edition. Chapter 1: Initial Assessment and Management. ISBN 78-0-9968262-3-5. American College of Surgeons, Chicago. 2018:2-22.
27. Sierink JC, Saltzherr TP, Reitsma JB, Van Delden OM, Luitse JS, Goslings JC. Systematic review and meta-analysis of immediate total-body computed tomography compared with selective radiological imaging of injured patients. Br J Surg. 2012;99 (Suppl 1):52-8.
28. van Vugt R, Kool DR, Deunk J, Edwards MJ. Effects on mortality, treatment, and time management as a result of routine use of total body computed tomography in blunt high-energy trauma patients. J Trauma Acute Care Surg. 2012;72(3):553-9.
29. Sampson MA, Colquhoun KB, Hennessy NL. Computed tomography whole body imaging in multi-trauma: 7 years experience. Clin Radiol. 2006;61:365-9.
30. Akdur O, Ozkan S, Durukan P, Avsarogullari L, Koyuncu M, Ikizceli I. Machine-related farm injuries in Turkey. Ann Agric Environ Med. 2010;17(1):59-63.
31. Cogbill TH, Busch HM Jr. The spectrum of agricultural trauma. J Emerg Med. 1985;3(3):205- 10.
32. Eraybar S, Atmaca S, Nennicioglu Y, Torun G, Aydin O, Varisli B, et al. Comparison of fatal injuries resulting from tractor and high speed motorcycle accidents in Turkey: A multicenter study. Emerg Med Int. 2019;2019:9471407.
33. Maslanka AM. Scoring systems and triage from the field. Emerg Med Clin North Am. 1993;11(1):15-27.
34. Orhon R, Eren Ş, Karadayı Ş, Korkmaz İ, Coşkun A, Eren M, et al. Comparison of trauma scores for predicting mortality and morbidity on trauma patients. Turk J Trauma Emerg Surg. 2014;20(4):258-64.
35. Jawa RS, Young DH, Stothert JC, Yetter D, Dumond R, Shostrom VK, et al. Farm machinery injuries: The 15-year experience at an urban joint trauma center system in a rural state. J Agromedicine. 2013;18(2):98-106.
36. Cogbill TH, Steenlage ES, Landercasper J, Strutt PJ. Death and disability from agricultural injuries in Wisconsin: A 12-year experience with 739 patients. J Trauma. 1991;31(12):1632-7.