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Lawnmower Injuries In Children: A National 13 Year Study Of Urban Vs Rural Injury Rates And The Impact Of Safety Guidelines
Ronit Shah, Divya Talwar, Theodore Ganley
Children's Hospital of Philadelphia, Philadelphia, PA

Background (issue): Although the AAOS, AAP, and POSNA have established lawnmower safety guidelines, a significant number of injuries continue to occur. We sought to elaborate upon the pediatric epidemiology of lawnmower injuries and compare urban vs. rural injuries.
Methods: The Pediatric Health Information System database was queried for patients aged 1-18 years from 2005-2017 who presented with lawnmower injuries. Results were computed using bivariate tests and multinomial regression.
Findings: There were a total of 1,302 lawnmower injuries identified (mean age 7.7 5.1 years, range 1-18 years; 78.9% males). Incidence rates by region, adjusted for regional case volume, were 2.16/100,000 cases in the South, 2.70/100,000 cases in the Midwest, 1.34/100,000 cases in the Northeast, and 0.56/100,000 cases in the Western United States. It was found that urban areas had an incidence rate of 1.47 injuries per 100,000 cases, while rural areas had a rate of 7.26 injuries per 100,000 cases (p<0.05). Patients with injuries in rural areas (5.0 4.3 years) were significantly younger that their urban (6.5 5.2 years) counterparts (p<0.05). Rural areas had higher rates of infection and higher percentages of patients requiring inpatient stay (p<0.05). Surgical complication rate in rural areas was 5.5% as compared to 2.6% in urban areas (p<0.05). Rural areas had an overall amputation rate of 15.5% compared to 9.6% in urban areas and were 1.7 times more likely to undergo an amputation (p<0.05).
Conclusions (implications for practice): The findings of this study show that significant disparities exist between urban and rural settings for children with lawnmower injuries.


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