一项针对儿科全地形车碰撞事故的前瞻性、多机构研究。
A prospective, multi-institutional study of pediatric all-terrain vehicle crashes.
机构信息
From the Department of Pediatric Surgery (I.M., M.T., K.B., H.S., G.L., G.B., S.T., B.T.C.), Connecticut Children's Medical Center, Hartford, Connecticut; Arkansas Children's Hospital (A.L.H., D.C.), Little Rock, Arkansas; and University of Massachusetts Memorial Health Care System (P.D.D., A.D.), Worcester, Massachusetts.
出版信息
J Trauma Acute Care Surg. 2014 Jul;77(1):103-8; discussion 107-8. doi: 10.1097/TA.0000000000000266.
BACKGROUND
Pediatric all-terrain vehicle (ATV) injuries have been increasing annually for more than a decade. The purpose of this study was to prospectively evaluate crash circumstances and clinical outcomes resulting from pediatric ATV crashes.
METHODS
Three pediatric trauma centers prospectively collected data from patients during their hospitalization for injuries sustained in ATV crashes from July 2007 through June 2012. Patients completed a 35-item questionnaire describing the crash circumstances (ATV engine size, safety equipment use, and training/experience). Clinical data (injuries, surgical procedures, etc.) were collected for each patient.
RESULTS
Eighty-four patients were enrolled, with a mean (SD) age of 13.0 (3.1) years, and were predominantly male (n = 55, 65%). Injuries were musculoskeletal (42%), central nervous system (39%), abdominal (20%), thoracic (16%), and genitourinary (4%). Multisystem injuries were prevalent (27%), and two patients died. Thirty-three patients (43%) required operative intervention. Most children were riding for recreation (96%) and ignored ATV manufacturers' recommendation that children younger than 16 years ride ATVs with smaller (≤90 cc) engines (71%). Dangerous riding practices were widespread: no helmet (70%), no adult supervision (56%), double riding (50%), riding on paved roads (23%), and nighttime riding (16%). Lack of helmet use was significantly associated with head injury (53% vs. 25%, p = 0.03). Rollover crashes were most common (44%), followed by collision with a stationary object (25%) or another vehicle (12%). Half (51%) of children said that they would ride an ATV again.
CONCLUSION
These data demonstrate a relationship between dangerous ATV riding behaviors and severe injuries in children who crash. Children younger than 16 years should not operate ATVs, and legislation that effectively restricts ATV use in children is urgently needed.
LEVEL OF EVIDENCE
Epidemiologic study, level III.
背景
儿童全地形车（ATV）事故在过去十年中每年都在增加。本研究旨在前瞻性评估儿童 ATV 事故的事故情况和临床结果。
方法
三个儿科创伤中心从 2007 年 7 月至 2012 年 6 月期间，前瞻性地收集因 ATV 事故而住院的患者数据。患者完成了一份 35 项问卷，描述了事故情况（ATV 发动机大小、使用安全设备以及培训/经验）。为每位患者收集了临床数据（损伤、手术程序等）。
结果
共纳入 84 例患者，平均（SD）年龄为 13.0（3.1）岁，主要为男性（n=55，65%）。损伤为肌肉骨骼（42%）、中枢神经系统（39%）、腹部（20%）、胸部（16%）和泌尿生殖系统（4%）。多系统损伤很常见（27%），有 2 例死亡。33 例（43%）患者需要手术干预。大多数孩子都是为了娱乐而骑车（96%），无视 ATV 制造商的建议，即年龄小于 16 岁的儿童应骑发动机较小（≤90cc）的 ATV（71%）。危险的骑行行为很普遍：不戴头盔（70%）、无成人监督（56%）、双人骑行（50%）、在铺砌道路上骑行（23%）和夜间骑行（16%）。未使用头盔与头部受伤显著相关（53%比 25%，p=0.03）。翻车事故最常见（44%），其次是与静止物体（25%）或另一车辆（12%）碰撞。一半（51%）的孩子表示他们会再次骑 ATV。
结论
这些数据表明，儿童 ATV 事故中，危险的 ATV 骑行行为与严重损伤之间存在关联。年龄小于 16 岁的儿童不应操作 ATV，迫切需要制定有效的 ATV 使用限制法规。
证据水平
流行病学研究，III 级。
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