Butts C Caleb, Rostas Jack W, Lee Y L, Gonzalez Richard P, Brevard Sidney B, Frotan M Amin, Ahmed Naveed, Simmons Jon D
Department of Surgery, University of South Alabama, United States.
Department of Surgery, University of Mississippi Medical Center, United States.
Injury. 2015 Apr;46(4):625-8. doi: 10.1016/j.injury.2014.11.007. Epub 2014 Nov 24.
Since the introduction of all-terrain vehicles (ATV) to the United States in 1971, injuries and mortalities related to their use have increased significantly. Furthermore, these vehicles have become larger and more powerful. As there are no helmet requirements or limitations on engine-size in the State of Alabama, we hypothesised that larger engine size would correlate with an increased incidence of traumatic brain injury (TBI) in patients following an ATV crash.
Patient and ATV data were prospectively collected on all ATV crashes presenting to a level one trauma centre from September 2010 to May 2013. Collected data included: demographics, age of driver, ATV engine size, presence of helmet, injuries, and outcomes. The data were grouped according to the ATV engine size in cubic centimetres (cc). For the purposes of this study, TBI was defined as any type of intracranial haemorrhage on the initial computed tomography scan.
There were 61 patients identified during the study period. Two patients (3%) were wearing a helmet at the time of injury. Patients on an ATV with an engine size of 350 cc or greater had higher Injury Severity Scores (13.9 vs. 7.5, p ≤ 0.05) and an increased incidence of TBI (26% vs. 0%, p ≤ 0.05) when compared to patients on ATV's with an engine size less than 350 cc.
Patients on an ATV with an engine size of 350 cc or greater were more likely to have a TBI. The use of a helmet was rarely present in this cohort. Legislative efforts to implement rider protection laws for ATVs are warranted.
自1971年全地形车（ATV）引入美国以来，与使用ATV相关的受伤和死亡人数显著增加。此外，这些车辆变得更大、动力更强。由于阿拉巴马州没有头盔要求或发动机尺寸限制，我们推测在ATV碰撞后，较大的发动机尺寸与创伤性脑损伤（TBI）患者发病率增加相关。
前瞻性收集2010年9月至2013年5月期间所有送至一级创伤中心的ATV碰撞患者及ATV数据。收集的数据包括：人口统计学资料、驾驶员年龄、ATV发动机尺寸、头盔佩戴情况、损伤及结局。数据按ATV发动机尺寸（立方厘米，cc）分组。在本研究中，TBI定义为初次计算机断层扫描时出现的任何类型的颅内出血。
研究期间共识别出61例患者。两名患者（3%）在受伤时佩戴了头盔。与发动机尺寸小于350 cc的ATV患者相比，发动机尺寸为350 cc或更大 的ATV患者的损伤严重度评分更高（13.9比7.5，p≤0.05），TBI发病率增加（26%比0%，p≤0.05）。
发动机尺寸为350 cc或更大的ATV患者更有可能发生TBI。该队列中很少有人使用头盔。有必要通过立法努力实施ATV骑手保护法。
