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 language | English (US) |
|---|---|
| Pages (from-to) | 1411-1415 |
| Number of pages | 5 |
| Journal | Journal of Pediatric Surgery |
| Volume | 54 |
| Issue number | 7 |
| DOIs | |
| State | Published - Jul 2019 |
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All Science Journal Classification (ASJC) codes
- Surgery
- Pediatrics, Perinatology, and Child Health
Keywords
- Injury severity
- Pediatric MVC
- Restraint mechanisms
Cite this
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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 journal › Article
TY - JOUR
T1 - Children after motor vehicle crashes
T2 - Restraint utilization and injury severity
AU - Findlay, Bridget Lang
AU - Melucci, Alexa
AU - Dombrovskiy, Viktor
AU - Pierre, Joelle
AU - Lee, Yi Horng
PY - 2019/7
Y1 - 2019/7
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.
KW - Injury severity
KW - Pediatric MVC
KW - Restraint mechanisms
UR - http://www.scopus.com/inward/record.url?scp=85056721132&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85056721132&partnerID=8YFLogxK
U2 - 10.1016/j.jpedsurg.2018.10.046
DO - 10.1016/j.jpedsurg.2018.10.046
M3 - Article
AN - SCOPUS:85056721132
VL - 54
SP - 1411
EP - 1415
JO - Journal of Pediatric Surgery
JF - Journal of Pediatric Surgery
SN - 0022-3468
IS - 7
ER -