Children after motor vehicle crashes: Restraint utilization and injury severity
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Read the article on jpedsurg.org ↗Article · Nov 2018 · 1 min read
In brief
In brief
Retrospective study of 477 hospitalized children after motor vehicle crashes found that improper restraint or lack of restraint significantly increased injury severity, with the youngest age group (0-7 years) having the highest rate of improper restraint use. While injury patterns were similar across restraint types, improperly restrained children had higher injury severity scores and were more likely to sustain profound injuries.
Written by the GCMD Library team from the article.
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.