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Sledding Behind Motorized Vehicles Associates With More Severe And Lethal Injuries
David N Hanna, Zaid Haddadin, Caroline Godfrey, Brittney Aiello, Amber L Greeno, *Harold N. Lovvorn, III
Vanderbilt University Medical Center, Nashville, TN

Background: Our institution has recently experienced an increase in sledding-related injuries, particularly when towed behind motorized vehicles. The purpose of this study was to characterize injury severity and outcomes between motorized and gravity sledding accidents.
Methods: This institutional, retrospective study queried all patients who presented with a sledding-related injury to our ACS-verified Level 1 Pediatric Trauma Center located in the Southeastern United States between 01/2015 to 03/2021. Demographics, injury details, and outcomes were compared between two groups: patients pulled behind a motorized vehicle (MOTORIZED) and those who were not (GRAVITY).
Findings: Of the 59 patients included in our analysis, none used protective equipment, and 13 (22%) were in the MOTORIZED group. No significant differences in demographics were detected between groups. Patients in the MOTORIZED group sustained higher injury severity (ISS) and lower GCS scores. Additionally, patients in this group more often received a blood transfusion and intubation, had longer intensive care and overall hospital lengths of stay, and incurred higher hospital costs. In a multivariate analysis, the use of a motorized vehicle was associated with increased ISS (OR: 9.7, 95% CI 1.9-17.5; p=0.02) . Deaths (n=2) only occurred if sledding behind a motorized vehicle.
Conclusions (implications for practice): Children who sustain a sledding accident in the Southeast often used motorized vehicles and experienced increased ISS and need for more intensive treatments. The use of motorized vehicles for sledding activities is strongly discouraged.

Patient Characteristics Between Sledding Mechanisms
VariableMotorized Vehicle (n=13)Gravity (n=46)p-value
Level 1 Trauma Activation30% (4)7% (3)0.02
Lowest GCS Score (mean std)11.5 5.114.5 1.60.006
Injurity Severity Score (mean std)20.3 13.710.4 6.40.02
Intubation15% (2)0% (0)0.04
ICU Admission54% (7)13% (6)0.006
Blood Transfusion31% (4)4.5% (2)0.02
ICU Length of Stay (mean std)8.8 6.1 days2.8 2.6 days0.04
Hospital Length of Stay (mean std)5.8 2.7 days2.2 1.9 days0.009
Hospital Cost (mean std)$124,522 101,788$43,667 39,5670.006


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