Children after motor vehicle crashes: Restraint utilization and injury severity

Bridget Lang Findlay, Alexa Melucci, Viktor Dombrovskiy, Joelle Pierre, Yi Horng Lee

Research output: Contribution to journalArticle

Abstract

Background: Although injury patterns after motor vehicle crashes (MVCs) are well documented, association between adequate restraint and injury severity is unclear. We aimed to determine if improper restraint affects injury rates and severity. Methods: A retrospective chart review of 477 children hospitalized in Pediatric Trauma Center after MVC was performed. Injuries in various age groups (0–7, 8–12, 13–16, 17–18 years) with different restraint quality measures (proper [PR] and improper/unrestrained [IUR]) as well as injury severity score (ISS: mild [1–9], moderate [10–15], severe [16–25], and profound [> 25]) were evaluated and compared. Chi-square and Wilcoxon rank-sum tests were used for statistics. Results: In all age groups head/neck injuries were most common (55–63%), while abdominal and pelvic injuries were least likely except group 8–12 years where abdominal injuries ranked third (17.1%). Overall, 64.5% had PR and 35.5% IUR. Interestingly, that greatest proportion of IUR was in the youngest age group (0–7). It decreased with aging and children aged 17–18 years were significantly less likely to be IUR compared to those 0–7 years (OR[odds ratio] = 0.58; 95%CI[confidence interval] 0.35–0.94). We did not find significant differences in rates of various injuries between PR and IUR. However, ISS severity in IUR was significantly greater than in PR (median with interquartile range 6(2–14) and 5(1–9), respectively; P = 0.001). As a result, IUR compared to PR were less likely to have mild ISS (OR = 0.6, 95%CI 0.39–0.90) but more likely to have profound ISS (OR = 3.3, 95%CI 1.48–7.43). Conclusion: Restraint quality has significant impact on injury severity in children after MVC. Level of Evidence: Level III.

Original languageEnglish (US)
Pages (from-to)1411-1415
Number of pages5
JournalJournal of Pediatric Surgery
Volume54
Issue number7
DOIs
StatePublished - Jul 2019

Fingerprint

Motor Vehicles
Wounds and Injuries
Abdominal Injuries
Age Groups
Nonparametric Statistics
Neck Injuries
Injury Severity Score
Hospitalized Child
Trauma Centers
Craniocerebral Trauma
Odds Ratio
Confidence Intervals
Pediatrics

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pediatrics, Perinatology, and Child Health

Keywords

  • Injury severity
  • Pediatric MVC
  • Restraint mechanisms

Cite this

Findlay, Bridget Lang ; Melucci, Alexa ; Dombrovskiy, Viktor ; Pierre, Joelle ; Lee, Yi Horng. / Children after motor vehicle crashes : Restraint utilization and injury severity. In: Journal of Pediatric Surgery. 2019 ; Vol. 54, No. 7. pp. 1411-1415.
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abstract = "Background: Although injury patterns after motor vehicle crashes (MVCs) are well documented, association between adequate restraint and injury severity is unclear. We aimed to determine if improper restraint affects injury rates and severity. Methods: A retrospective chart review of 477 children hospitalized in Pediatric Trauma Center after MVC was performed. Injuries in various age groups (0–7, 8–12, 13–16, 17–18 years) with different restraint quality measures (proper [PR] and improper/unrestrained [IUR]) as well as injury severity score (ISS: mild [1–9], moderate [10–15], severe [16–25], and profound [> 25]) were evaluated and compared. Chi-square and Wilcoxon rank-sum tests were used for statistics. Results: In all age groups head/neck injuries were most common (55–63{\%}), while abdominal and pelvic injuries were least likely except group 8–12 years where abdominal injuries ranked third (17.1{\%}). Overall, 64.5{\%} had PR and 35.5{\%} IUR. Interestingly, that greatest proportion of IUR was in the youngest age group (0–7). It decreased with aging and children aged 17–18 years were significantly less likely to be IUR compared to those 0–7 years (OR[odds ratio] = 0.58; 95{\%}CI[confidence interval] 0.35–0.94). We did not find significant differences in rates of various injuries between PR and IUR. However, ISS severity in IUR was significantly greater than in PR (median with interquartile range 6(2–14) and 5(1–9), respectively; P = 0.001). As a result, IUR compared to PR were less likely to have mild ISS (OR = 0.6, 95{\%}CI 0.39–0.90) but more likely to have profound ISS (OR = 3.3, 95{\%}CI 1.48–7.43). Conclusion: Restraint quality has significant impact on injury severity in children after MVC. Level of Evidence: Level III.",
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Children after motor vehicle crashes : Restraint utilization and injury severity. / Findlay, Bridget Lang; Melucci, Alexa; Dombrovskiy, Viktor; Pierre, Joelle; Lee, Yi Horng.

In: Journal of Pediatric Surgery, Vol. 54, No. 7, 07.2019, p. 1411-1415.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Children after motor vehicle crashes

T2 - Restraint utilization and injury severity

AU - Findlay, Bridget Lang

AU - Melucci, Alexa

AU - Dombrovskiy, Viktor

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N2 - Background: Although injury patterns after motor vehicle crashes (MVCs) are well documented, association between adequate restraint and injury severity is unclear. We aimed to determine if improper restraint affects injury rates and severity. Methods: A retrospective chart review of 477 children hospitalized in Pediatric Trauma Center after MVC was performed. Injuries in various age groups (0–7, 8–12, 13–16, 17–18 years) with different restraint quality measures (proper [PR] and improper/unrestrained [IUR]) as well as injury severity score (ISS: mild [1–9], moderate [10–15], severe [16–25], and profound [> 25]) were evaluated and compared. Chi-square and Wilcoxon rank-sum tests were used for statistics. Results: In all age groups head/neck injuries were most common (55–63%), while abdominal and pelvic injuries were least likely except group 8–12 years where abdominal injuries ranked third (17.1%). Overall, 64.5% had PR and 35.5% IUR. Interestingly, that greatest proportion of IUR was in the youngest age group (0–7). It decreased with aging and children aged 17–18 years were significantly less likely to be IUR compared to those 0–7 years (OR[odds ratio] = 0.58; 95%CI[confidence interval] 0.35–0.94). We did not find significant differences in rates of various injuries between PR and IUR. However, ISS severity in IUR was significantly greater than in PR (median with interquartile range 6(2–14) and 5(1–9), respectively; P = 0.001). As a result, IUR compared to PR were less likely to have mild ISS (OR = 0.6, 95%CI 0.39–0.90) but more likely to have profound ISS (OR = 3.3, 95%CI 1.48–7.43). Conclusion: Restraint quality has significant impact on injury severity in children after MVC. Level of Evidence: Level III.

AB - Background: Although injury patterns after motor vehicle crashes (MVCs) are well documented, association between adequate restraint and injury severity is unclear. We aimed to determine if improper restraint affects injury rates and severity. Methods: A retrospective chart review of 477 children hospitalized in Pediatric Trauma Center after MVC was performed. Injuries in various age groups (0–7, 8–12, 13–16, 17–18 years) with different restraint quality measures (proper [PR] and improper/unrestrained [IUR]) as well as injury severity score (ISS: mild [1–9], moderate [10–15], severe [16–25], and profound [> 25]) were evaluated and compared. Chi-square and Wilcoxon rank-sum tests were used for statistics. Results: In all age groups head/neck injuries were most common (55–63%), while abdominal and pelvic injuries were least likely except group 8–12 years where abdominal injuries ranked third (17.1%). Overall, 64.5% had PR and 35.5% IUR. Interestingly, that greatest proportion of IUR was in the youngest age group (0–7). It decreased with aging and children aged 17–18 years were significantly less likely to be IUR compared to those 0–7 years (OR[odds ratio] = 0.58; 95%CI[confidence interval] 0.35–0.94). We did not find significant differences in rates of various injuries between PR and IUR. However, ISS severity in IUR was significantly greater than in PR (median with interquartile range 6(2–14) and 5(1–9), respectively; P = 0.001). As a result, IUR compared to PR were less likely to have mild ISS (OR = 0.6, 95%CI 0.39–0.90) but more likely to have profound ISS (OR = 3.3, 95%CI 1.48–7.43). Conclusion: Restraint quality has significant impact on injury severity in children after MVC. Level of Evidence: Level III.

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KW - Restraint mechanisms

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