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Pediatric “Off-Road Vehicle” Trauma: Determinants of Injury Severity and Type

Sandler, Gideon BSc, MBBS, MS, DCH*; Soundappan, Soundappan SV MBBS, MS, MCh, FRACS*; Manglick, Maria P. MSc*†; Fahy, Fiona E. CNC, BSc (App Sci Nursing), MIN*; Ross, Frank CNC, BSc (App Sci Nursing), MPH; Lam, Lawrence PhD†‡; Cass, Danny FRACS, PhD*

doi: 10.1097/PEC.0b013e318276b0d2
Original Articles

Objectives This study aimed to describe the determinants of the severity and type of injuries sustained by children hurt in off-road vehicle (ORV) accidents.

Methods This was a retrospective clinical study for which data were obtained from the trauma database at the Children’s Hospital at Westmead covering the 10-year period between January 1, 1998, and December 31, 2007. Data points collected included age, sex, Injury Severity Score (ISS), body region injured, type of vehicle, accident setting, mechanism of injury, estimated speed, position of the rider, use of a helmet and/or protective clothing, and hospital length of stay. The study end points were determinants of injury severity and type. Statistical analysis of the collected data was done with the standard statistical software package, SPSS.

Results A total of 288 children (242 male [84%] and 46 female [16%] patients) presented for ORV-related trauma. Helmets significantly diminished the chance of sustaining a head injury occasioning a skull fracture. Jumping was associated with increased ISS and a higher chance of sustaining an abdominal and/or thoracic injury. Older children were more likely to sustain pelvic and spinal injures, be injured while traveling at high speed, and be injured while going over a jump. Mean ISS was significantly lower if trauma was sustained while riding a mini motorcyle in any setting and any ORV at home.

Conclusions Further research (prospective, federal, and multi-institutional) is needed with a view to optimizing training schedules, rules, regulations, and licensing requirements for pediatric ORV riders.

From the *Department of Academic Surgery, †The Centre of Trauma Care, Prevention, Education, and Research, The Children’s Hospital at Westmead; and ‡Discipline of Paediatrics and Child Health, Faculty of Medicine, The University of Sydney, Westmead, South Wales, Australia.

Disclosure: The authors declare no conflict of interest

Reprints: Gideon Sandler, BSc, MBBS, MS, DCH, The Childrens Hospital at Westmead, Locked Bag 4001, Westmead 2145, Sydney, Australia (e-mail:

We acknowledge the support of the New South Wales Institute of Trauma and Injury Management, which provided a grant to the corresponding author during the completion of his Masters of Surgery (Paed). This study is derived from the thesis written for that degree.

© 2012 Lippincott Williams & Wilkins, Inc.