Neurosurgical analysis of logging accidents: An observational study

Objective: Forestry is one of the most dangerous occupations with record high rates of accidents and mortality relative to other occupations. In the past, related studies have been conducted within the scope of occupational safety, occupational health, and public health. Clinical studies on this subject are extremely rare and not within the scope of neurosurgery. We intended to facilitate the management of logging accidents for physicians by conducting a clinical study on logging accidents. This first-of-its-kind study also aimed to comprehend the injury mechanisms in order to contribute to the efforts made to prevent injuries and to facilitate the management of these cases.Methods: The hospital records of patients who presented at the Karabuk University EAH Emergency Department owing to logging accidents between 1/1/2019 and 5/1/2020 in the Karabuk province were retrospectively analyzed. The information about patient profile, demographic information, mechanism of the logging injury, and the patterns of spinal and cranial injuries as well as other body area injuries (if any) were retrieved from the hospital records. The spinal and cranial injury patterns were analyzed from the imaging records (MRI or CT).Results: A total of 19 subjects were included in this analysis, of which 5 had cranial injury (26.3%), 2 had spinal injury (10.5%), 1 (5.2%) had both cranial and spinal injuries (this subject died in the intensive care unit at follow-up). A total of 9 (47%) subjects died. Three subjects were followed up for observation (15.7%), while 5 (26.3%) were referred to the department of orthopedics. The cranial and spinal injuries were accompanied by additional injuries such as rib fracture, hemothorax, fibula fracture, and pneumothorax. These injuries occurred in pathological conditions such as cardiac arrhythmia, facial paralysis, and epilepsy. One subject developed spinal cord damage (5.2%) that progressed to neurological shock and crash syndrome. Overall, 19 injuries occurred mainly due to 5 different mechanisms.Conclusions: The patterns of resultant spinal and cranial injuries and the related demographic information would facilitate efficient patient management. Understanding the injury mechanisms would facilitate both the management and diagnosis of such cases and the prevention of logging accidents through combined efforts of occupational safety and public health specialists.