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Nationwide Evaluation of Trends in ATV Related Injuries in Children
Ilan I Maizlin, MD, Robert T Russell, MD, MPH. Department of Pediatric Surgery, Children's Hospital of Alabama, University of Alabama at Birmingham, Birmingham, AL,USA.

Background: The inherent risk of all-terrain vehicles (ATV) has been recognized since their introduction in the 1970s. However, ATV operating remains an unregulated activity in many states. We aim to identify the circumstances and clinical outcomes resulting from pediatric ATV accidents.

Methods: The National Trauma Database (2010-2012) was reviewed for patients <19 years of age admitted following ATV accidents. Patients were stratified into 3 age-groups: 0-6 years, 7-12 years, 13-19 years. Demographics, patterns of injury, and outcomes were evaluated, with chi-square and ANOVA tests used for analysis.

Results: 19,607 children (75.4% male) were involved in ATV-related traumas, with mean age of 134.3 years. 9,493 (48.4%) of the injured were drivers, 8,558 (43.6%) were passengers, and 1,556 (8%) were not riding the ATV. Over 14% of the traumas occurred on paved roads. Only 29% of the children were helmeted, and the lowest rate was among the youngest group (<19%). Mean hospital stay was 3.2 days, with 20% of the patients admitted to the ICU, and 6.5% requiring ventilator support. Overall mortality was 0.84%. Compared to younger age-groups, patients 13-19 years old had longer mean hospital stay (3.5 days, p=0.05), higher rate of ICU admissions (23%, p=0.05), and greater ventilator requirements (8.3%, p=0.04). The oldest group also had the highest associated mortality (0.95%, p=0.02).

Conclusions: ATV use results in a significant number of pediatric injuries and trauma-related admissions, especially in the 13-19 year old age-group. Safety guidelines mandating helmet use and prohibiting the operating of ATVs on paved roads must be considered.

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