Patient Outcome from Nontraditional Motorized Vehicle Accidents

INTRODUCTION There have been little literature between the effect of patient’s ages and health outcome from nontraditional motor vehicle accidents (NMVA). These accidents are known as not car or motorcycle or truck accidents on the highways. This study examined the effect of NMVA and age on outcome of adult patients treated at the Johnson City Medical Center for over 7 years. MATERIALS AND METHODS This study was approved by the office for the protection of human research projects of East Tennessee State University. A total of 468 patients aged \u3e18 years involved in motorized vehicle accidents other than traditional cars, trucks or motorcycles from 2011 to 2017 were analyzed. Electronic health data of trauma patients was obtained from the Johnson City Medical Center trauma department registry. Patients were selected if primary reason for admission was injury due to nontraditional motorized vehicle (snow mobiles, lawn mowers, all-terrain vehicles (ATV’s), machinery- industrial or agricultural, and any other nontraditional motorized vehicle that was not a car or truck or motorcycle. The study design was observational (cross sectional survey). The International Classification of Diseases, Ninth Edition (ICD-9) and Tenth Edition (ICD-10) were used to obtain parameters for the study. The study parameters include Age Length of stay (LOS) Total length of stay in the ICU Total ventilator days Injury severity score (ISS) Mechanism of injury The health data and medical information were kept private, secured and safeguarded. The patients were split into three groups, ages 18 – 60 (study group 1), ages 61-89 (study group 2), and ages 90+ (study group 3).Descriptive statistics and Logistic regression were used to compare means and analyze each study parameters between the study groups. Finally, a comparison was done between study groups 1 and 2 of patients involved in ATV accidents using the same categories. Other NMVA such as lawn mower, machinery were not analyzed based on few fatalities. The analysis was done using SPSS, SAS v9.4. RESULTS There were a total of 468 observed patients, 18 died and 450 survived. Out of the 18 patients that died, 12 were in study group one while 6 were study group two. Of the 450 that survived, 5 were discharged to an acute care facility, 363 home or self-care (routine discharge), 40 in a rehabilitation facility (inpatient), 38 in skilled nursing facility. Overall the tests show that there was no difference between the groups observed except when comparing the total length of stay and total ICU days among patients in the study group 1 that were involved in all accidents. (Total ICU days P= 0.0028, total length of stay P= 0.003). The patients who survived on average spent 3 days longer in the hospital and 1 day longer in the Intensive care unit. CONCLUSION The patient outcome from nontraditional accident differs only by length of hospital stay and total ICU days among patients between ages 18 -60. Further longitudinal studies will help to identify other reasons for prolong stay in the hospital