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Freeman JM, Keatley MN, Wong SHX, Brown AM, Webster EL. A Qualitative Enquiry of On-Farm Rules About Quad Bikes (ATVs): How Rules Are Determined and Implemented at a Farm Level in Rural Australia. J Agromedicine 2024:1-11. [PMID: 38898777 DOI: 10.1080/1059924x.2024.2368181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2024]
Abstract
OBJECTIVE Quad bikes are a leading cause of death and incident-related injury on farms, yet little is understood about rules used by farmers to ensure their safe operation. This study explored rules about quad bikes set by those who live or work on farms. Through the case of quad bikes, this study sought to understand how rules are determined and implemented at the farm level. SETTING A mix of farm types and locations in rural Australia including Queensland, South Australia, and New South Wales. PARTICIPANTS Eight farmers were interviewed and recruited from information sheets at farmers' markets, through a local health organisation, and a media release. DESIGN Thematic analysis was used to transform data from eight semi-structured interviews with farmers in rural Australia. RESULTS Data were distilled into two themes - "Rule content" described the explicit rules farmers had set on their properties, while the theme "Underlying rule principles" explored the values and norms which underpinned the creation and implementation of these rules. CONCLUSIONS Through the case of quad bike rules, this study illustrated how rules are determined and implemented at the farm level. Perceptions of risk were tied to farmers being experts in their own environment and therefore able to mitigate risk. In contrast to injury data, reckless use of quad bikes was perceived to cause incidents, and this was the basis of rules for adults and children.
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Affiliation(s)
- Joseph Michael Freeman
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- School of Rural Health, The University of Sydney, Dubbo, New South Wales, Australia
| | - Megan Nicole Keatley
- School of Rural Health, The University of Sydney, Dubbo, New South Wales, Australia
| | - Sarah Hui Xin Wong
- School of Rural Health, The University of Sydney, Dubbo, New South Wales, Australia
| | - Anthony M Brown
- School of Rural Health, The University of Sydney, Dubbo, New South Wales, Australia
| | - Emma Louise Webster
- School of Rural Health, The University of Sydney, Dubbo, New South Wales, Australia
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Renfro KN, Eckhoff MD, Trevizo GAG, Dunn JC. Traumatic Finger Amputations: Epidemiology and Mechanism of Injury, 2010-2019. Hand (N Y) 2024; 19:278-285. [PMID: 36154498 PMCID: PMC10953531 DOI: 10.1177/15589447221122826] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
BACKGROUND Traumatic finger amputations are a common and well-known hand injury, yet there are few studies addressing long-term epidemiologic data and associated mechanisms of injury. This paper aims to use a large national database to identify the relationship of patient demographics and mechanism of injury in finger amputations. METHODS The National Electronic Injury Surveillance System (NEISS) was queried for finger amputations in the United States from 2010 to 2019. Patient demographic information was collected and analyzed by gender, race, age, and further statistical analysis was performed to determine correlations with consumer products. RESULTS Finger amputations accounted for an estimated 234,304 emergency department visits from 2010 to 2019. Most of the patients were male (79%) and identified as white (46.2%). The most commonly implicated products overall were power saws and related power tools, followed by doors and then lawn mowers. A bimodal age incidence was observed with the highest incidence rates occurring in children ages 0 to 4, followed by a second peak incidence rate in the adults ages 65 to 74. The most common mechanisms of injury were found to differ in patients less than 19 and those 20 and over. CONCLUSION Traumatic finger amputations have a bimodal incidence with changing epidemiology and mechanism of injury with age. The first peak occurs from ages 0 to 4, involves predominantly doors, and has a male to female ratio of 1.30. The second peak occurs from ages 65 to 74, involves mostly power saws, and has a male to female ratio of 6.68. LEVEL OF EVIDENCE Prognostic, Level IV.
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Affiliation(s)
| | | | | | - John C. Dunn
- William Beaumont Army Medical Center, El Paso, TX, USA
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3
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Lyons JG, Mian HM, Via GG, Brueggeman DA, Krishnamurthy AB. Trends and epidemiology of knee extensor mechanism injuries presenting to United States emergency departments from 2001 to 2020. PHYSICIAN SPORTSMED 2023; 51:183-192. [PMID: 34965844 DOI: 10.1080/00913847.2021.2024775] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES Injuries to the native extensor mechanism (EM) of the knee are potentially disabling and often require surgical treatment. Large-scale, updated epidemiological data on these injuries is lacking. The objective of the current study was to examine recent trends in EM injuries presenting to United States (US) Emergency Departments (EDs) over the last 20 years using a nationally representative sample. METHODS This study retrospectively analyzed the National Electronic Injury Surveillance System (NEISS) database to identify cases of EM injuries (defined as either a quadriceps tendon rupture, a patella fracture, or a patellar tendon rupture) presenting to EDs in the US from 2001 to 2020. RESULTS During the study period, an estimated 214,817 EM injuries occurred in an at-risk population of 6,183,899,410 person-years for an overall incidence rate of 3.47 per 100,000 person-years. Patella fractures (PFs) were the most common injury type, representing 77.5% of all EM injuries (overall incidence rate: 2.69), followed by patellar tendon ruptures (PTRs; 13.5%; incidence: 0.48) and quadriceps tendon ruptures (QTRs; 9%; incidence: 0.31). Demographic characteristics and mechanisms of injury differed between injury types. Annual incidence rates increased significantly during the study period for all EM injury types, with PTRs demonstrating the largest relative increase (average annual percent increase: PF, 2.8%; PTR, 7.2%; QTR, 5.3%). Accounting for population growth yielded an increasing incidence of all EM injuries combined from 3.65 in 2001 to 4.9 in 2020. The largest relative increases in incidence rates were observed in older age groups. CONCLUSION Extensor mechanism injuries of the knee are increasing in the US, which likely reflects an aging and more active population. These types of injuries are associated with substantial functional impairment and recent increases in incidence rates highlight the need for injury prevention and management strategies.
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Affiliation(s)
- Joseph G Lyons
- Department of Orthopaedic Surgery, Wright State University Boonshoft School of Medicine, Dayton, OH, USA
| | - Humza M Mian
- Department of Orthopaedic Surgery, Wright State University Boonshoft School of Medicine, Dayton, OH, USA
| | - Garrhett G Via
- Department of Orthopaedic Surgery, Wright State University Boonshoft School of Medicine, Dayton, OH, USA
| | - David A Brueggeman
- Department of Orthopaedic Surgery, Wright State University Boonshoft School of Medicine, Dayton, OH, USA
| | - Anil B Krishnamurthy
- Department of Orthopaedic Surgery, Wright State University Boonshoft School of Medicine, Dayton, OH, USA
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Ganga A, Kim EJ, Araia ES, Hagan M, Shao B, Svokos K, Klinge PM, Cielo DJ, Fridley JS, Gokaslan ZL, Toms SA, Sullivan PZ. Pediatric all-terrain vehicle (ATV) related head injury rates and patterns: A 10-year nationwide analysis. Am J Emerg Med 2023; 67:56-62. [PMID: 36804750 DOI: 10.1016/j.ajem.2023.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 12/23/2022] [Accepted: 02/07/2023] [Indexed: 02/12/2023] Open
Abstract
INTRODUCTION The use of all-terrain vehicles (ATVs) carries significant risk of permanent injury and death, disproportionately affecting children. These injuries commonly affect the head and are especially severe among children as they are often unhelmeted and more likely than adults to experience rollover injuries. Many studies examining patients with ATV-related injuries are single-center cohort studies, with few focusing specifically on head injuries. In the present study, we aimed to characterize the annual incidence of ATV-related head injuries between 2012 and 2021, classify and compare head injury types, and identify descriptive characteristics of ATV-related head injury victims. METHODS Using the US Consumer Product Safety Commission's National Electronic Injury Surveillance System (NEISS) database, we queried all head injuries associated with operating or riding an ATV in children under 18 years-old from over 100 emergency departments (EDs). Patient information regarding age, race, sex, location of incident, diagnoses, and sequelae were analyzed. We also collected the estimated number of ATV-related head injuries from all US EDs using the NEISS algorithm provided by the database. RESULTS Using the NEISS algorithm we identified 67,957 (95% CI: 43,608 - 92,305) total pediatric ATV-related head injuries between 2012 and 2021. The annual incidence of ATV-related head injury was similar throughout this study period except for a 20% increase during the COVID-19 pandemic period of 2019-2021 (2019: 6382 injuries, 2020: 6757 injuries, 2021: 7600 injuries). A subset of 1890 cases from approximately 100 EDs were then analyzed. Unspecified closed head injuries were the prevailing type of injury (38%, 900/1890), followed by concussions (27%, 510/1890). More severe injuries included intracranial hemorrhages in 91 children (3.8%, 91/1890). Injuries of all types were predominantly seen in 14-17 year-old's (780/1890, 41%) and in males (64.1%, 1211/1890). In addition, ATV-associated injuries were significantly more common in those coded as white (58.0%, 1096/1890) than any other racial group. ATV-associated accidents among children younger than 9 more commonly occurred at the home compared to accidents involving children older than 9 (57% vs. 32%, p < 0.0001). CONCLUSION ATV-related head injuries cause a significant annual burden among children, with growing incidence in recent years. Further research may wish to explore potential benefits of helmet use and supervision of younger children in possible prevention of these accidents and their associated economic and non-economic costs.
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Affiliation(s)
- Arjun Ganga
- Warren Alpert School of Medicine, Brown University, Providence, RI 02903, United States of America; Department of Neurosurgery, Warren Alpert School of Medicine, Brown University, Providence, RI 02903, United States of America
| | - Eric J Kim
- Warren Alpert School of Medicine, Brown University, Providence, RI 02903, United States of America
| | - Ermias S Araia
- Warren Alpert School of Medicine, Brown University, Providence, RI 02903, United States of America
| | - Matthew Hagan
- Warren Alpert School of Medicine, Brown University, Providence, RI 02903, United States of America; Department of Neurosurgery, Warren Alpert School of Medicine, Brown University, Providence, RI 02903, United States of America
| | - Belinda Shao
- Warren Alpert School of Medicine, Brown University, Providence, RI 02903, United States of America; Department of Neurosurgery, Warren Alpert School of Medicine, Brown University, Providence, RI 02903, United States of America
| | - Konstantina Svokos
- Warren Alpert School of Medicine, Brown University, Providence, RI 02903, United States of America; Department of Neurosurgery, Warren Alpert School of Medicine, Brown University, Providence, RI 02903, United States of America
| | - Petra M Klinge
- Warren Alpert School of Medicine, Brown University, Providence, RI 02903, United States of America; Department of Neurosurgery, Warren Alpert School of Medicine, Brown University, Providence, RI 02903, United States of America
| | - Deus J Cielo
- Warren Alpert School of Medicine, Brown University, Providence, RI 02903, United States of America; Department of Neurosurgery, Warren Alpert School of Medicine, Brown University, Providence, RI 02903, United States of America
| | - Jared S Fridley
- Warren Alpert School of Medicine, Brown University, Providence, RI 02903, United States of America; Department of Neurosurgery, Warren Alpert School of Medicine, Brown University, Providence, RI 02903, United States of America
| | - Ziya L Gokaslan
- Warren Alpert School of Medicine, Brown University, Providence, RI 02903, United States of America; Department of Neurosurgery, Warren Alpert School of Medicine, Brown University, Providence, RI 02903, United States of America
| | - Steven A Toms
- Warren Alpert School of Medicine, Brown University, Providence, RI 02903, United States of America; Department of Neurosurgery, Warren Alpert School of Medicine, Brown University, Providence, RI 02903, United States of America
| | - Patricia Zadnik Sullivan
- Warren Alpert School of Medicine, Brown University, Providence, RI 02903, United States of America; Department of Neurosurgery, Warren Alpert School of Medicine, Brown University, Providence, RI 02903, United States of America.
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Sorenson TJ, Rich MD, Lamba A, Deitermann A, Barta RJ, Schubert W. Recreational Motorized Vehicle Use Under the Influence of Alcohol or Drugs Significantly Increases Odds of Craniofacial Injury. Craniomaxillofac Trauma Reconstr 2022; 15:282-287. [PMID: 36387321 PMCID: PMC9647382 DOI: 10.1177/19433875211046721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2023] Open
Abstract
Study Design Cross-sectional study. Objective Concurrent substance-use, including alcohol and drugs, increases the risks of many recreational activities. Our purpose was to determine the relationship between substance use and craniofacial injuries in a large population of patients experiencing trauma due to recreational motorized vehicle use. Methods We report a cross-sectional study of patients reported to the National Electronic Injury Surveillance System (NEISS) from January 1, 2019 to December 31, 2019, in the United States. Patients were included in our study if they were evaluated in the emergency department (ED) for a recreational motorized vehicle-related injury. Primary outcome was craniofacial injury. Results There were a total of 6,485 adult patients who experience an injury after recreational motorized vehicle trauma reported by NEISS-participating EDs during the study period. Of this, 1,416 (21.8%) patients had a craniofacial injury, and 201 patients with craniofacial injuries were under the influence of alcohol/drugs (201/1,416; 14.2%). Injured patients under the influence of alcohol/drugs experienced greater odds of sustaining a general craniofacial injury (OR 2.50, 95% CI: 2.07-3.01, P < .0001), including craniofacial fracture (OR: 2.98, 95% CI: 2.01-4.40, P < .0001), laceration (OR: 2.19, 95% CI: 1.51-3.16, P < .00001) and internal injury (OR: 2.33, 95% CI: 1.84-2.95, P < .00001) than injured patients not under the influence. Conclusions Using recreational motorized vehicles under the influence of alcohol or drugs is not safe and increases the likelihood of craniofacial injuries, including fractures, lacerations, and internal injuries. As operating these recreational motorized vehicles under the influence is illegal, the law should be strictly enforced to prevent the occurrence of these injuries. Additional undertakings to increase helmet usage would be valuable.
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Affiliation(s)
| | - Matthew D. Rich
- Division of Plastic Surgery, Department
of Surgery, University of Minnesota, Minneapolis, MN, USA
| | - Abhinav Lamba
- Medical School, University of
Minnesota, Minneapolis, MN, USA
| | | | - Ruth J. Barta
- Division of Plastic Surgery, Department
of Surgery, University of Minnesota, Minneapolis, MN, USA
- Department of Plastic and Hand Surgery,
Regions Hospital, Saint Paul, MN, USA
| | - Warren Schubert
- Division of Plastic Surgery, Department
of Surgery, University of Minnesota, Minneapolis, MN, USA
- Department of Plastic and Hand Surgery,
Regions Hospital, Saint Paul, MN, USA
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Fonseca JA, Guerrero G, Leiner M, Khilji O, Intal L, Ayoub-Rodriguez L, Pathak I. Factors Affecting Neurological Presentation and Severity in Pediatric Off-Highway Vehicle Accidents in Texas. South Med J 2022; 115:674-680. [PMID: 36055654 DOI: 10.14423/smj.0000000000001441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES The purpose was to evaluate the characteristics of off-highway vehicle (OHV) crashes correlated with neurological injury and accident severity in the pediatric population in El Paso, Texas. METHODS A retrospective review of 213 patients who were victims of an OHV crash attended at a regional Level I trauma center from 2012 to 2020 was performed. OHVs were defined as vehicles designated for use outside public roads. Neurological outcomes included any traumatic brain injury (TBI) or a brain hemorrhage/hematoma. Severe injury was defined as a Glasgow Coma Scale less than 8, a length of stay longer than 7 days, a Pediatric Trauma Score lower than 8, and requiring pediatric intensive care unit admission. Bivariate and multivariate analyses by logistic regression models were conducted to determine the factors related to the neurological outcomes and accident severity. RESULTS Of 213 OHV crash patients, 104 (48.8%) had TBI and 22 (10.3%) had brain hemorrhages or hematomas. Risk analyses demonstrated that children younger than age 6 years and occupants of recreational OHVs have a significantly higher risk of severe injuries. Off-highway motorcycles and all-terrain vehicles were risk factors for TBI, whereas helmets were a protective factor. CONCLUSIONS OHVs are associated with both TBIs and severe injuries. Stricter laws requiring helmets and forbidding children younger than 6 to ride are required, as modifying these factors could reduce the incidence of OHV crashes and their complications.
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Affiliation(s)
- Jairo A Fonseca
- From the Department of Pediatrics, Foster School of Medicine, Texas Tech University Health Sciences Center El Paso
| | - Gustavo Guerrero
- From the Department of Pediatrics, Foster School of Medicine, Texas Tech University Health Sciences Center El Paso
| | - Marie Leiner
- From the Department of Pediatrics, Foster School of Medicine, Texas Tech University Health Sciences Center El Paso
| | - Ohmed Khilji
- From the Department of Pediatrics, Foster School of Medicine, Texas Tech University Health Sciences Center El Paso
| | - Lyca Intal
- From the Department of Pediatrics, Foster School of Medicine, Texas Tech University Health Sciences Center El Paso
| | - Lisa Ayoub-Rodriguez
- From the Department of Pediatrics, Foster School of Medicine, Texas Tech University Health Sciences Center El Paso
| | - Indu Pathak
- From the Department of Pediatrics, Foster School of Medicine, Texas Tech University Health Sciences Center El Paso
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Mulligan CS, Adams S, Moeller H, Whyte T, Soundappan SSV, Brown J. Comparative analysis of off-road vehicle crashes in children: motorcycles versus quad bikes. Inj Prev 2022; 28:526-532. [PMID: 35831029 DOI: 10.1136/ip-2022-044573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 06/10/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To characterise and compare off-road motorcycle and quad bike crashes in children in New South Wales (NSW), Australia. METHODS A retrospective, cross-sectional study was performed of children aged 0-16 years, admitted to hospitals in NSW, from 2001 to 2018 following an injury sustained in an off-road motorcycle or quad bike crash, using linked hospital admissions, mortality and census data.Motorcycle and quad bike injuries were compared regarding: demographics; incidence; body region injured and type of injury; injury severity based on the survival risk ratio; length of stay and mortality. RESULTS There were 6624 crashes resulting in hospitalisation; 5156 involving motorcycles (77.8%) and 1468 involving quad bikes (22.2%). There were 10 fatalities (6 from motorcycles and 4 from quad bikes). The rates of injury declined over the study period for motorcycles, but not for quad bikes.Motorcycle riders were more likely than quad bike riders to have lower limb injuries (OR 1.49, p<0.001) but less likely to have head/neck (OR 0.616, p<0.001), abdominal (OR 0.778, p=0.007) and thoracic (OR 0.745, p=0.003) injuries. Quad bike crashes resulted in higher injury severity (mean International Classification Injury Severity Score 0.975 vs 0.977, p=0.03) and longer hospital stay (mean 2.42 days vs 2.09 days, p=0.01). CONCLUSIONS There are significant differences between quad bike and motorcycle crashes in injury type and affected body region. While quad bike injuries in children were more severe, there were almost four times more hospitalisations from motorcycles overall. The overall larger burden of motorcycle crashes suggests a greater focus of injury prevention countermeasures for two-wheeled riders is needed.
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Affiliation(s)
| | - Susan Adams
- Paediatric Surgery, Sydney Children's Hospital Randwick, Randwick, New South Wales, Australia
| | - Holger Moeller
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Tom Whyte
- Injury Group, Neuroscience Research Australia, Randwick, New South Wales, Australia
| | | | - Julie Brown
- Injury Group, The George Institute for Global Health, Newtown, New South Wales, Australia
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Goldwag JL, Porter ED, Wilcox AR, Li Z, ScD TDT, Crockett AO, Wolffing AB, Mancini DJ, Martin ED, Scott JW, Briggs A. Geriatric All-Terrain Vehicle Trauma: An Unhelmeted and Severely Injured Population. J Surg Res 2021; 270:555-563. [PMID: 34826691 DOI: 10.1016/j.jss.2021.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 08/17/2021] [Accepted: 09/16/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND All-terrain vehicle (ATV) use is widespread, however, little is known about injury patterns and outcomes in geriatric patients. We hypothesized that geriatric patients would have distinct and more severe injuries than non-geriatric adults after ATV trauma. METHODS A retrospective cohort study was performed using the National Trauma Databank comparing non-geriatric (18-64) and geriatric adults (≥65) presenting after ATV trauma at Level 1 and 2 trauma centers from 2011 to 2015. Demographic, admission, and outcomes data were collected, including injury severity score (ISS), abbreviated injury scale (AIS) score, discharge disposition, and mortality. We performed univariate statistical tests between cohorts and multiple logistic regression models to assess for risk factors associated with severe injury (ISS>15) and mortality. RESULTS 23,568 ATV trauma patients were identified, of whom 1,954 (8.3%) were geriatric. Geriatric patients had higher rates of severe injury(29.2 v 22.5%,p<0.0001), and thoracic (55.2 v 37.8%,p<0.0001) and spine (31.5 v 26.0%,p<0.0001) injuries, but lower rates of abdominal injuries (14.6 v 17.9%,p<0.001) as compared to non-geriatric adults. Geriatric patients had overall lower head injury rates (39.2 v 42.1%,p=0.01), but more severe head injuries (AIS>3) (36.2 vs 30.2%,p<0.001). Helmet use was significantly lower in geriatric patients (12.0 v 22.8%,p<0.0001). On multivariate analysis age increased the odds for both severe injury (OR 1.50, 95% CI 1.31-1.72, p<0.0001) and mortality (OR 5.07, 95% CI 3.42-7.50, p<0.0001). CONCLUSIONS While severe injury and mortality after ATV trauma occurred in all adults, geriatric adults suffered distinct injury patterns and were at greater risk for severe injury and mortality.
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Affiliation(s)
- Jenaya L Goldwag
- Department of Surgery, Dartmouth-Hitchcock Medical Center, 1 Medical Center Dr, Lebanon, NH, 03756
| | - Eleah D Porter
- Department of Surgery, Dartmouth-Hitchcock Medical Center, 1 Medical Center Dr, Lebanon, NH, 03756
| | - Allison R Wilcox
- Department of Surgery, Dartmouth-Hitchcock Medical Center, 1 Medical Center Dr, Lebanon, NH, 03756
| | - Zhongze Li
- Biomedical Data Science Department, Geisel School of Medicine at Dartmouth College
| | - Tor D Tosteson ScD
- Biomedical Data Science Department, Geisel School of Medicine at Dartmouth College
| | - Andrew O Crockett
- Department of Surgery, Dartmouth-Hitchcock Medical Center, 1 Medical Center Dr, Lebanon, NH, 03756; Geisel School of Medicine, 1 Rope Ferry Rd, Hanover, NH, 03755
| | - Andrea B Wolffing
- Department of Surgery, Dartmouth-Hitchcock Medical Center, 1 Medical Center Dr, Lebanon, NH, 03756; Geisel School of Medicine, 1 Rope Ferry Rd, Hanover, NH, 03755
| | - D Joshua Mancini
- Department of Surgery, Dartmouth-Hitchcock Medical Center, 1 Medical Center Dr, Lebanon, NH, 03756; Geisel School of Medicine, 1 Rope Ferry Rd, Hanover, NH, 03755
| | - Eric D Martin
- Department of Surgery, Dartmouth-Hitchcock Medical Center, 1 Medical Center Dr, Lebanon, NH, 03756; Geisel School of Medicine, 1 Rope Ferry Rd, Hanover, NH, 03755
| | - John W Scott
- Department of Surgery, University of Michigan, Ann Arbor, MI, 48109
| | - Alexandra Briggs
- Department of Surgery, Dartmouth-Hitchcock Medical Center, 1 Medical Center Dr, Lebanon, NH, 03756; Geisel School of Medicine, 1 Rope Ferry Rd, Hanover, NH, 03755.
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Li D, Jatana KR, Kistamgari S, Smith GA. Nonfatal All-Terrain Vehicle-Related Head and Neck Injuries to Children Treated in US Emergency Departments. Clin Pediatr (Phila) 2020; 59:1141-1149. [PMID: 32772567 DOI: 10.1177/0009922819901011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study investigates children <18 years old with nonfatal all-terrain vehicle (ATV)-related head and neck injuries treated in United States emergency departments by analyzing data from the National Electronic Injury Surveillance System from 1990 to 2014. An estimated 279 391 children received emergency treatment during the 25-year study period. The number of injuries remained relatively constant from 1990 to 1997, increased by 142.9% from 1997 to 2007, and then decreased by 37.4% from 2007 to 2014. The most common diagnoses were concussion/closed head injury (32.6%) and fracture (32.6%); 15.4% of children were admitted. The most common injury mechanisms include ejection (30.0%), crash (18.8%), and rollover (15.8%). Patients who were injured on a street/highway were 1.49 times (95% confidence interval = 1.11-1.99) more likely to be admitted than patients injured at other locations. Although the number of nonfatal ATV-related head and neck injuries decreased during the latter part of the study period, they remain common and can have serious medical outcomes.
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Affiliation(s)
- Daniel Li
- Nationwide Children's Hospital, Columbus, OH, USA.,The Ohio State University, Columbus, OH, USA
| | - Kris R Jatana
- Nationwide Children's Hospital, Columbus, OH, USA.,The Ohio State University, Columbus, OH, USA
| | | | - Gary A Smith
- Nationwide Children's Hospital, Columbus, OH, USA.,The Ohio State University, Columbus, OH, USA.,Child Injury Prevention Alliance, Columbus, OH, USA
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Jordan RW, Beckmann NM, Johnston JH, Johnston SK, Zhang X, Chinapuvvula NR. Characterization of all-terrain vehicle-related thoracolumbar spine injury patterns in children using the AOSpine classification system. Emerg Radiol 2020; 27:383-391. [PMID: 32103381 DOI: 10.1007/s10140-020-01762-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 02/11/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE To evaluate thoracolumbar spine injury patterns, demographics, and clinical characteristics in pediatric patients following all-terrain vehicle-related trauma. METHODS A retrospective review of patients 0-17 years old admitted to a level I trauma center following an ATV-related incident from 2004 to 2013 was performed. Thoracolumbar spine injury patterns, accident mechanism, driver/passenger status, and demographic and clinical data were compared between patients with and without a spine injury. RESULTS Of 456 pediatric patients involved in ATV-related trauma, 36 sustained one or more thoracolumbar spine injuries (7.9%). These patients tended to be older, taller, heavier, and had a higher BMI. ATV rollover was the major statistically significant mechanism of injury to cause spine fractures (61%). Patients with spine injuries had twice the hospital length of stay compared with those without (4 days vs. 2 days, P = 0.003). Nonstructural spine injuries (A0) were the most common type of injury (49.1%), followed by wedge-compression fractures (A1) (41.1%). In patients with a thoracolumbar spine injury, there was a mean of 3.11 spine injuries per child. Four (10%) patients with thoracolumbar spine fractures also sustained a cervical spine fracture. CONCLUSION Once a thoracolumbar spine injury has been detected in a patient, the entire spinal column should be scrutinized because there is a high likelihood for additional injuries throughout the spine. Younger pediatric patients (≤ 8 years old) exhibit a spine fracture pattern distinct from that of older children who have a mature osseous-ligamentous complex.
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Affiliation(s)
- Roger W Jordan
- Department of Diagnostic & Interventional Imaging, McGovern Medical School, The University of Texas Health Science Center at Houston, 6431 Fannin Street, 2.130B, Houston, TX, 77030, USA.
| | - Nicholas M Beckmann
- Department of Diagnostic & Interventional Imaging, McGovern Medical School, The University of Texas Health Science Center at Houston, 6431 Fannin Street, 2.130B, Houston, TX, 77030, USA
| | - Jennifer H Johnston
- Department of Diagnostic & Interventional Imaging, McGovern Medical School, The University of Texas Health Science Center at Houston, 6431 Fannin Street, 2.130B, Houston, TX, 77030, USA
| | - Sean K Johnston
- Department of Diagnostic & Interventional Imaging, McGovern Medical School, The University of Texas Health Science Center at Houston, 6431 Fannin Street, 2.130B, Houston, TX, 77030, USA
| | - Xu Zhang
- Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, 6431 Fannin Street, 2.130B, Houston, TX, 77030, USA.,Biostatistics/Epidemiology/Research/Design Core, Center for Clinical and Translational Sciences, The University of Texas Health Science Center at Houston, 6410 Fannin, UTPB 1100.08, Houston, TX, 77030, USA
| | - Naga R Chinapuvvula
- Department of Diagnostic & Interventional Imaging, McGovern Medical School, The University of Texas Health Science Center at Houston, 6431 Fannin Street, 2.130B, Houston, TX, 77030, USA
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Siman-Tov M, Marom-Trabelsi I, Radomislensky I, Bodas M, Peleg K. Injuries among all-terrain vehicle users: a population-based study. Inj Prev 2020; 26:540-545. [DOI: 10.1136/injuryprev-2019-043425] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 11/13/2019] [Accepted: 11/17/2019] [Indexed: 11/04/2022]
Abstract
BackgroundThe use of off-road vehicles such as all-terrain vehicles (ATVs) and recreational off-highway vehicles has increased in recent years. A higher percentage of patients hospitalised following ATV crashes suffered severe injuries, compared with those hospitalised following other MVCs.ObjectiveTo identify incidence of ATV-related injury and characterise groups with higher prevalence.MethodsA retrospective study of the Israel National Trauma Registry data between years 2008 and 2016. ATV crash victims were compared with other types of MVC casualties according to demographics, injuries and hospital resource utilisation. Identifying groups with greater prevalence for severe injuries caused by ATV crashes was conducted using logistic regressions.ResultsAn increase of 49% in the number of casualties hospitalised following an ATV crash was observed between 2013 and 2016. Non-Jews, males and users 15–29 years old were hospitalised at a higher rate compared with their proportion in the population. ATV crash casualties were more severely injured compared with other MVC casualties (22% vs 14%), had longer hospital length of stay (8+ days) (25% vs 18%), more admissions to intensive care units (16% vs 10%) and underwent more surgery (39% vs 26%, respectively). Males, non-Jews and casualties who did not wear a helmet were about two times more likely to suffer from severe head injury (95% CI 1.20 to 3.60, 1.41 to 2.75 and 1.27 to 4.73, respectively).ConclusionsAn increase in ATV-related casualties was observed. A customised safety intervention programme is needed that targets demographic groups identified with higher injury incidence. Awareness of legislated and common sense ATV safety practices, specifically helmet use, should be raised.
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Orthopaedic injuries from snowmobile accidents: a multi-centre analysis of demographics, injury patterns, and outcomes. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY 2019; 29:1617-1621. [PMID: 31359179 DOI: 10.1007/s00590-019-02514-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 07/22/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE More than 2 million people in North America use snowmobiles, resulting in an estimated 200 fatalities and 14,000 injuries annually. The purpose of this study is to document the demographics, orthopaedic injury patterns, and short-term outcomes of patients with snowmobile-related injuries. MATERIALS AND METHODS A retrospective review was performed at two regional trauma centres in a region where snowmobile use is prevalent. Patients who sustained snowmobile-related injuries over a 12-year period were identified from the hospitals' trauma registries using E-codes (E820-E820.9). Patient demographics were recorded, as were injury characteristics including rates of substance use, open fractures, Injury Severity Score (ISS), Abbreviated Injury Score (AIS) for the extremities, and mortality. Rates of inpatient surgery, as well as hospital and ICU length of stay (LOS), were also recorded. RESULTS We identified 528 patients with snowmobile-related injuries. Average age was 37 years, and 418 patients (79%) were male. Eighty-eight per cent of all patients with snowmobile injuries were admitted to the hospital with an average LOS of 5.7 days. Among those admitted to the hospital, average ISS was 12.3, and 28% of these patients had ISS > 15. A total of 261 patients (56%) suffered extremity injuries (including 163 upper and 173 lower extremity fractures) with an average extremity AIS of 2.4. There were 700 total fractures (1.5 per patient), and 9% of all fractures were open. A total of 208 patients (45%) suffered head injuries, and 132 patients (28%) sustained vertebral column fractures. A total of 201 patients (43%) required inpatient surgery, and eight patients (1.7%) sustained fatal injuries. CONCLUSIONS We present a detailed multi-centre analysis of orthopaedic injury patterns and outcomes resulting from snowmobile-related injuries. Patients injured while snowmobiling share similar injury patterns with patients injured in motorcycle and other high-energy motor vehicle accidents.
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Specialty Focus: Trauma Issue. J Am Acad Orthop Surg 2018; 26:627-628. [PMID: 30192269 DOI: 10.5435/jaaos-d-18-00418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
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