{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T17:25:11Z","timestamp":1787851511590,"version":"build-2784847793"},"reference-count":15,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T00:00:00Z","timestamp":1787529600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"abstract":"<jats:p>Agriculture remains one of the most hazardous industries in the United States, and livestock-related trauma represents an important source of injury in rural communities. As the agricultural workforce ages, understanding age-related differences in farm animal-related trauma has become increasingly important. Methods: We performed a retrospective multicenter cohort study of patients presenting with farm animal-related injuries to three regional trauma centers in Southern Appalachia between 2015 and 2024. Patients were stratified into geriatric (\u226565\u00a0years) and non-geriatric (&lt;65\u00a0years) groups. Demographics, comorbidities, injury characteristics, Injury Severity Score (ISS), Abbreviated Injury Scale (AIS) by body region, interventions, and clinical outcomes were compared. Results: A total of 333 patients were included, of whom 60 (18.0%) were geriatric. Older adults were significantly more likely to sustain cow\/bull-related injuries, while younger patients more frequently sustained horse-related injuries. Geriatric patients demonstrated greater injury severity, higher rates of rib fractures, femur fractures, lower-extremity fractures, and flail chest. Older adults also had higher odds of ICU admission, transfusion, and were less likely to be discharged directly home. Discussion: Farm animal-related trauma in older adults is associated with greater injury severity, increased thoracic and lower-extremity injury burden, higher transfusion requirements, increased health care resource utilization, and lower rates of discharge home. As the agricultural workforce continues to age, targeted injury-prevention strategies and trauma-system planning efforts should focus on reducing the burden of livestock-related injury among older agricultural workers.<\/jats:p>","DOI":"10.1177\/00031348261480825","type":"journal-article","created":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T02:40:37Z","timestamp":1787625637000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Farm Animal-Related Trauma in an Aging Agricultural Workforce: A Multicenter Retrospective Cohort Study in Southern Appalachia"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-8492-4373","authenticated-orcid":false,"given":"Gabriella","family":"Cote","sequence":"first","affiliation":[{"name":"ETSU Quillen College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kalli","family":"Devecki","sequence":"additional","affiliation":[{"name":"Ballad Health"},{"name":"ETSU Department of Surgery"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keelin","family":"Roche","sequence":"additional","affiliation":[{"name":"Ballad Health"},{"name":"ETSU Department of Surgery"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"King","sequence":"additional","affiliation":[{"name":"Ballad Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Collins","sequence":"additional","affiliation":[{"name":"Ballad Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr.","given":"J. Bracken","family":"Burns","sequence":"additional","affiliation":[{"name":"Ballad Health"},{"name":"ETSU Department of Surgery"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,24]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.26616\/NIOSHPUB2001153"},{"key":"e_1_3_3_3_2","unstructured":"Centers for Disease Control and Prevention National Institute for Occupational Safety and Health. Agriculture Worker Safety and Health. Updated May 16 2024. Accessed June 13 2026.https:\/\/www.cdc.gov\/niosh\/agriculture\/about\/index.html"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/ajim.20686"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.4103\/JETS.JETS_92_20"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.35746"},{"issue":"29","key":"e_1_3_3_7_2","first-page":"800","article-title":"Fatalities caused by cattle \u2014 four states, 2003-2008","volume":"58","author":"Centers for Disease Control and Prevention","year":"2009","unstructured":"Centers for Disease Control and Prevention. Fatalities caused by cattle \u2014 four states, 2003-2008. MMWR Morb Mortal Wkly Rep. 2009;58(29):800-804.","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"e_1_3_3_8_2","volume-title":"2017 Census of Agriculture: United States Summary and State Data. Volume 1, Geographic Area Series, Part 51","author":"United States Department of Agriculture, National Agricultural Statistics Service","year":"2019","unstructured":"United States Department of Agriculture, National Agricultural Statistics Service. 2017 Census of Agriculture: United States Summary and State Data. Volume 1, Geographic Area Series, Part 51. United States Department of Agriculture; 2019. https:\/\/www.nass.usda.gov\/Publications\/AgCensus\/2017\/Full_Report\/Volume_1,_Chapter_1_US\/usv1.pdf"},{"key":"e_1_3_3_9_2","unstructured":"United States Senate Special Committee on Aging. Feeding the future: challenges and opportunities for aging farmers. 2023. https:\/\/www.aging.senate.gov\/imo\/media\/doc\/senate_aging_farmers_report.pdf. Accessed 13 June 2026."},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-200101000-00021"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cger.2012.10.008"},{"key":"e_1_3_3_12_2","volume-title":"Agriculture and Local Food Economies in the Appalachian Region","author":"Appalachian Regional Commission","year":"2022","unstructured":"Appalachian Regional Commission. Agriculture and Local Food Economies in the Appalachian Region. Appalachian Regional Commission; 2022. https:\/\/www.arc.gov\/report\/agriculture-and-local-food-economies-in-the-appalachian-region\/. Accessed 13 June 2026."},{"key":"e_1_3_3_13_2","volume-title":"Health Disparities in Appalachia","author":"Marshall JL","year":"2017","unstructured":"Marshall JL, Thomas L, Lane NM, et al. Health Disparities in Appalachia. Appalachian Regional Commission; 2017. https:\/\/www.arc.gov\/wp-content\/uploads\/2020\/06\/Health_Disparities_in_Appalachia_August_2017.pdf. 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