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Golf Cart Injuries in Children: An Analysis of State Trauma Centers Over a 5-year Period Compared to All-terrain Vehicles
Henry L. Chang1, *Brian Yorkgitis2, Lindsey B. Armstrong1, *Keith A. Thatch1, *Donald A. Plumley3, Robin T. Petroze4, Shawn D. Larson4, *John W. Fitzwater5, Oliver Lao6, *Michele Markley7, Anne Fischer8, Felipe Pedroso9, Holly L. Neville6, *Christopher W. Snyder1
1Johns Hopkins All Children's Hospital, St. Petersburg, FL;2University of Florida - Jacksonville, Jacksonville, FL; 3Arnold Palmer Hospital for Children, Orlando, FL; 4University of Florida, Gainesville, FL; 5St. Joe's Children's, Tampa, FL; 6Joe DiMaggio Children's Hospital, Hollywood, FL; 7Broward Health, Plantation, FL; 8St. Mary's Medical Center, West Palm Beach, FL; 9Nicklaus Children's Hospital, Miami, FL

Background: Golf carts (GCs) and all-terrain vehicles (ATVs) are popular forms of personal transport. While ATVs are considered adventurous and dangerous, GCs are perceived to be safer. Recent data indicate an increasing incidence of GC injuries. Anecdotal observation suggests the severity of GC injuries are disparate from their perception as safe. A statewide comparison of GC and ATV patients was performed to evaluate these injury mechanisms.
Methods: All pediatric trauma centers within the state were invited to submit trauma registry patients age <16 years from January 2016-June 2021. Patients with GCs or ATVs as the mechanism of injury were identified. Group comparisons were performed using chi-square analysis for categorical and Kruskal-Wallis analysis for continuous variables.
Results: From 10 trauma centers with 23,539 patients, 181 GC and 522 ATV injuries were identified. GC and ATV injuries increased over the study period. GC and ATV patients were predominantly white (83% vs. 75%, p-0.16) males (57% vs. 61%, p=0.2). GC patients were younger (11y, IQR 6-14y vs. 12y, IQR 9-14y, p=0.0015). Injury severity (ISS, GC 5 vs. ATV 5, p=0.27), hospitalization (GC 86% vs ATV 87%, p=0.6), ICU admission (GC 20% vs ATV 16%, p=0.24), immediate operative intervention (GC 11% vs ATV 11%, p=0.96), and mortality (GC 1.7% vs. ATV 1.4%, p=0.72) were similar between the groups.
Conclusions: State-level data over a 5.5-year period reveals an increasing incidence of GC and ATV injuries. Despite their perception as safe transport, GCs had similar injury severity and mortality to ATVs with similar rates of hospitalization, operative intervention, and ICU admission. Perceptions of GC as a non-threatening mode of transport should be re-examined.

Table 1. Comparison between golf cart and all-terrain vehicle injuries.
Golf Cart (n=181)All-Terrain Vehicle (n=522)p-value
Age (years)11 (IQR 6-14)12 (IQR 9-14)0.0015
ISS5 (IQR 4-10)5 (IQR 4-10)0.27
ICU Admission36 (20%)84 (16%)0.24
Immediate Operation20 (11%)57 (11%)0.96
Death3 (1.7%)7 (1.4%)0.72

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