Unsafe at Any Age: A Retrospective Review of All-Terrain Vehicle Injuries in Two Level I Trauma Centers from 1995 to 2003

Abstract

All-terrain vehicles (ATVs) are popular recreational and utility vehicles. In 1984, Cogbill published an article regarding three-wheelers. These are no longer manufactured, but the injury and death rate with four-wheeled ATVs is high and disproportionately affects young riders. We conducted a retrospective review at two Level I trauma centers from January 1994 to April 2003. Statistical analysis was performed using the SAS V8.2 program. Values of p < 0.05 were significant. Two hundred eight patients were identified. There were no differences identified in demographics, mechanism, types of injury, Injury Severity Score (ISS), or Glasgow Coma Scale (GCS) score. Seventy-five percent were male and 84% were white. The mean age was 23 +/- 13 years. The average ISS was 12.3 +/- 9 and the mean GCS score was 13.1 +/- 3.7. Injury mechanisms were loss of stability (33%), separation of rider from ATV (32%), and ATV versus stationary object (27%). ISS for ages 12 to 15 years was significantly higher than for other ages (14.5 vs. 11.5, p = 0.04, Wilcoxon rank sum test) and included more major head injuries (40.4% vs. 21.8%, p = 0.09, Wilcoxon rank sum test). They experienced fewer spinal fractures (3.9% vs. 15.4%, p = 0.03) and pelvic injuries (0% vs. 9%, p = 0.02, Wilcoxon rank sum test). The GCS score in this group was lower (12.3 vs. 13.4, p = 0.03, Wilcoxon rank sum test). Adolescent ATV riders have more severe injuries and more head injuries than other age groups. Prevention efforts should target this group.