Total Prehospital Time and Tractor Injuries: A Nebraska State Trauma Registry Analysis

Background: Agriculture is a hazardous industry, with tractor-related incidents being among the leading causes of traumatic injury and death. These injuries tend to take place far away from hospitals, thus leading to increased prehospital time to receive care. Understanding the relationship between prehospital time and outcomes such as hospital length of stay and mortality in the state of Nebraska could inform resource allocation for tractor related injuries.

Study design: A 10-year retrospective study abstracting adults involved in tractor injuries using The Nebraska State Trauma Registry was performed. Mortality was evaluated using standard logistic regression, while length of stay outcomes were estimated using the negative binomial distribution. Adjusted model covariates included age, arrived from status, and Injury Severity Score.

Results: A total of 100 tractor-related injuries were included. Extremity injuries made up the largest percentage of injury types (44%). Injury severity scores were considered low in most patients. The majority of injuries were experienced by a party not operating the tractor. After adjusting for age, the scene of patient arrival, and Injury Severity Score, total prehospital time was not a significant predictor of facility length of stay or mortality.

Conclusion: Access to care is an ongoing problem for many communities in the United States, with the Midwest having some of the largest regions with poor access to care. We did not find a significant relationship between prehospital time and outcomes related to length of stay or mortality. Future studies should assess for differences in outcomes among accident types such as roll-over accidents vs collisions.