IMPACT OF NON-AUTOMOBILE ROLLOVER ACCIDENTS ON PATIENT OUTCOMES AT AN APPALACHIAN LEVEL I TRAUMA CENTER

Objectives: The use of non-automobile vehicles (all-terrain vehicles (ATVs), lawnmowers, and tractors) are common in the rural setting. The objective of this study was to evaluate the outcomes of patients involved in rollover accidents in non-automobile vehicles in a rural Level I trauma center and use this information to develop injury prevention measures for these accident mechanisms. Several studies have investigated the effects of rollovers in each of these vehicles individually, however, there are no studies that investigate rollovers as a whole cohort.

Methods: This was a retrospective study including a total of 127 patients from January 2017 to June 2022 who were admitted to our level I trauma center following a rollover accident in either of the following vehicles: ATV, lawnmower, or tractor. The group was evaluated based on characteristics including age less than or greater than 65 and gender. Several other data points were collected including total hospital and ICU days, ventilator days, and injury severity score (ISS). T-tests, chi-squared, and ANOVA tests were used for statistical analysis.

Results: The mean ages between the three vehicle types were 44, 62.6, and 64.4 years old in the ATV, lawnmower, and tractor groups, respectively. Patients were significantly older in the tractor and lawnmower rollover groups. Patients less than 65 years old were significantly more likely to sustain an injury in a rollover accident when compared to those greater than 65. There was no significant difference between the number of injury types and the motorized vehicle they were using or number of injury types and age group. There were no statistically significant differences in total hospital days, total ICU days, ventilator days, or ISS between the three rollover groups. However, there were significant differences in discharge planning between the rollover groups with patients involved in lawnmower rollovers to be discharged to a care facility more often compared to the other groups.

Conclusion: Non-automobile rollovers have the potential to cause traumatic injuries, however, there does not appear to be one vehicle type that is more prone to injury. The study results suggest that the rollover accident population is likely a subset of elderly patients who have continued to partake in outdoor activities (lawn mowing and farming) despite increasing age. We hope that this study will reveal the need for awareness regarding the presence of rollover accidents in the rural setting. Eventually, we hope to develop injury prevention protocols for our area.