Changes in Patterns of Trauma Injuries in the Dakotas Region During the COVID-19 Pandemic.

BACKGROUND: The aim of this study is to compare impact of COVID-19 on trauma volume and characteristics on a set of trauma centers with a rural catchment area. The COVID-19 pandemic has affected different parts of the country quite differently, both in case volume and in local responses. State-wide responses have varied considerably, including variations in local mask mandates, school closures, and social distancing measures. METHODS: This was a retrospective trauma registry review of patients who were admitted to three of the tertiary care trauma centers in North and South Dakota between 2014 through 2022. RESULTS: In the analysis of 36,397 patients, we found a significant increase in trauma patient volume during the COVID-19 pandemic, with an increased percentage of patients presenting with a mechanism of injury secondary to abuse or assault. This increase in patient volume continued to rise during 2021 and 2022. CONCLUSIONS: Our study demonstrates how the COVID-19 pandemic impacted trauma center admissions in the rural and frontier Midwest differently from more urban areas, and the importance of including a variety of settings in trauma research.

Children and youth agricultural injuries: A retrospective analysis of pediatric trauma admissions in North Dakota.

Introduction: Farm children and youths face unique health risks, including increased risk of agricultural injuries (AI), due to the hazardous machinery, structures and animals on their residential environment. As a result, they experience more severe and complex polytraumatic injuries and longer hospital stays compared to those children injured in homes or residences. A major barrier to the prevention of AI among children and youth residing on farms is a lack of analytic studies about the magnitude and characteristics of these injuries, especially in North Dakota. Methods: We performed a retrospective review of the Sanford Medical Center Fargo trauma registry for pediatric patients (aged 0-19 years) who received care between January 2010 and December 2020 for AI. Patients were grouped for analysis by the age categories of the Agricultural Youth Work Guidelines (AYWG) to compare the mechanisms of injury with the recommended minimum age requirements for specific farm tasks. Results: Of the 41 patients, 26 were male. Mean age was 11 years and one death was reported. The most common mechanism of injury was animals (37%), followed by falls (20%) and machinery (17%). Children under 6 years and youth aged 16 to 19 had the highest number of injuries. Females experienced 53% of animal-related injuries and males accounted for all vehicle-related injuries. Conclusion: The incidence and severity of polytraumatic AI among young children in North Dakota is concerning. Our results underscore the continued need to pursue pediatric injury prevention on farms through educational resources and programs, including the AWYG. Practical applications: Parents require more training on age and ability appropriate farm tasks, especially animal-related interactions. It is imperative that families are given the education and training necessary to integrate children into the farm life while protecting them from injury.

Farm Machinery Injuries: A Retrospective Analysis of Admissions at a Level I Trauma Center in North Dakota.

OBJECTIVES: The purpose of the present study was to characterize the incidence, injury characteristics, and outcomes of patients presented to a Level I adult trauma center in Fargo, North Dakota, with farm machinery injuries (FMI). METHODS: We performed a retrospective review of the trauma registry of Sanford Medical Center Fargo (SMCF) between January 2010 and December 2020. We compared admission characteristics of FMI admissions to non-FMI admissions, identified the types of machinery that are most commonly associated with FMI, and described the nature of these injuries by severity, anatomical site, type, age, sex, and length of stay (LoS). Injury severity was evaluated using Injury Severity Score (ISS). RESULTS: Findings indicated that FMI admissions had a higher mean ISS, longer ICU LoS, and a higher mortality rate than non-FMI admissions. The leading cause of fatal and non-fatal FMI in this region are tractors. Males experience 91.2% of tractor injuries, and individuals 65 and over account for nearly 53% of all tractor injuries (n = 18). Males accounted for all deaths, tractor and otherwise. The "other machinery" category was the second most common category and accounted for 50% of female patients. Additionally, 24.5% of all FMI are related to machine maintenance. CONCLUSION: The findings from this study indicate that FMI injuries represent a significant problem in the upper Midwest. Older, male farm workers experience a higher incidence of tractor-related injuries, and all tractor-related deaths occurred in individuals 65 years of age and older. These results underscore the need for further investigation into aging-related farm safety issues.