Emergency medical services for children assessment of all-terrain vehicle–related injuries in Illinois

Abstract

Study objectives: This study seeks to describe injuries in children related to all-terrain vehicle (ATV) use during a 4-year period in Illinois before development of an injury prevention program. Methods: Patients were identified using a state Trauma Registry Database that is composed of data from 67 hospitals within Illinois designated as either a Level I or Level II trauma center. Patients entered into the state database met the following criteria: sustained an injury that required treatment at a trauma center and admission to a trauma center, transferred to a trauma center, died on arrival to the hospital, or died in the emergency department. The Trauma Registry identified ATV-related injuries using E-codes. Four age groups (0 to 4, 5 to 9, 10 to 14, and 15 to 16 years) were retrospectively reviewed between 1998 and 2001. Patients were categorized into nonhelmeted, helmeted, or unknown helmet use rider status. Results: Two hundred seventy-five (80 nonhelmeted, 56 helmeted, and 139 unknown helmet use) children aged 16 years or younger in Illinois sustained ATV-related injuries during the study period. One hundred forty-three (52%) of the patients were between 10 and 14 years old. Extremities were the most frequently injured body region in nonhelmeted (61), helmeted (47), and unknown helmet use (113) groups (76%, 84%, and 82%, respectively). Head and neck injuries were the second most common category of injury in the nonhelmeted (44), the helmeted (29), and in the unknown helmet use group (62; 55%, 52%, and 45%, respectively). The nonhelmeted group had a cumulative length of stay in the hospital of 228 days compared with the helmeted and unknown helmet use group length of stay of 137 days and 400 days, respectively. The nonhelmeted group and helmet use unknown group had a similar number of cumulative days in the ICU of 58 days and 52 days, respectively, compared with the helmeted group of 20 cumulative days in the ICU. The cumulative hospital charges for the nonhelmeted, helmeted, and unknown helmet use rider groups were $754,096, $457,409, and $1,269,314, respectively, for a total of $2,480,819. The 10- to 14-year-old age group comprised the highest percentage of total hospital charges of $1,330,585 (54%). Conclusion: The majority of pediatric ATV-related injuries in Illinois occurred in the 10- to 14-year-old age group. Upper and lower extremity injuries were the most common type of injury. The cost of injuries increased throughout the study period, similar to national trends. As the incidence of ATV injuries in children continues to increase, injury prevention programs should target methods to reduce injuries of extremities and head and neck, especially in the 10- to 14-year-old age group.