Testerman George M
Wellmont Holston Valley Medical Center, Kingsport, USA.
Tenn Med. 2009 Aug;102(8):45-7.
All-terrain vehicle (ATV) riding is a popular recreation in the mountainous areas of Southeastern Kentucky, Southwest Virginia and East Tennessee. We hypothesized that admissions for serious injuries have increased among ATV riders. A retrospective data review from a Level 1 trauma center trauma registry presents injury characteristics and outcomes, comparing patients in earlier and later time periods.
Patient demographics, drug and alcohol positivity, helmet use, injury type and location, internal disposition (admission to the Operating Room or Intensive Care Unit [ICU]), Injury Severity Score (ISS), Glasgow Coma Scale (GCS), Functional Independence Measure (FIM), hospital length of stay, ICU length of stay, ventilator days, Abbreviate Injury Score (AIS), scores for head and neck, chest, abdomen, and extremities, procedures performed, complications, and discharge destination were analyzed among individuals who had sustained ATV crash-related injuries between March 1997 and March 2007. Further stratification of patients admitted in the last six years to earlier and later time periods was done to detect trends. Analysis was done with Chi-square test, Student t-test, and multiple logistic regression with ANOVA. A p-value of < 0.05 determined significance.
ATV crash injury patients have increased by 78 percent (p < 0.01) over the last three years. Injury severity and clinical variables were similar. Fortunately, pediatric admissions (age less 16 years) were significantly decreased. Average age of patients trended toward older age groups. Pre-injury drug and/or alcohol use was documented in 40 percent, and 96 percent were not wearing a helmet. Nine patients died in the last six years (3.6 percent), the majority from closed head injuries. At discharge, 86 percent of patients went home and seven percent were transferred to a rehab facility.
There has been a recent dramatic increase in the number of injured ATV riders requiring admission to the Level I trauma center. Injury severity and outcomes have not changed. Fortunately, pediatric ATV-related admissions have decreased. Trauma centers should continue efforts toward preventive care, teaming with citizens, parents, public officials, and other healthcare providers to combat this epidemic.
在肯塔基州东南部、弗吉尼亚州西南部和田纳西州东部的山区，全地形车（ATV）骑行是一项广受欢迎的娱乐活动。我们推测，全地形车骑行者中因重伤入院的人数有所增加。通过对一家一级创伤中心创伤登记处的数据进行回顾性分析，呈现了损伤特征和结果，并对早期和后期的患者进行了比较。
对1997年3月至2007年3月期间因全地形车碰撞受伤的个体，分析其患者人口统计学资料、药物和酒精检测阳性情况、头盔使用情况、损伤类型和部位、内部处置（进入手术室或重症监护病房[ICU]）、损伤严重程度评分（ISS）、格拉斯哥昏迷量表（GCS）、功能独立性测量（FIM）、住院时间、ICU住院时间、呼吸机使用天数、简明损伤评分（AIS）、头部和颈部、胸部、腹部及四肢的评分、所进行的手术、并发症及出院去向。对过去六年入院的患者进一步按早期和后期进行分层，以检测趋势。采用卡方检验、学生t检验以及带有方差分析的多元逻辑回归进行分析。p值<0.05为有统计学意义。
在过去三年中，全地形车碰撞受伤患者增加了78%（p<0.01）。损伤严重程度和临床变量相似。幸运的是，儿科入院患者（年龄小于16岁）显著减少。患者的平均年龄呈向年龄较大组发展的趋势。40%的患者在受伤前有药物和/或酒精使用记录，96%的患者未佩戴头盔。在过去六年中有9名患者死亡（3.6%），大多数死于闭合性颅脑损伤。出院时，86%的患者回家，7%的患者被转至康复机构。
最近，需要入住一级创伤中心的受伤全地形车骑行者数量急剧增加。损伤严重程度和结果没有改变。幸运的是，与儿科全地形车相关的入院人数有所减少。创伤中心应继续努力开展预防护理工作，与市民、家长、政府官员及其他医疗服务提供者合作，应对这一流行问题。
