Prevention of all-terrain vehicle injuries: A systematic review from The Eastern Association for the Surgery of Trauma

Rattan, Rishi; Joseph, D’Andrea; Dente, Christopher J.; Klein, Eric; Kimbrough, Mary K.; Nguyen, Jonathan; Simmons, Jon D.; OʼKeeffe, Terence; Crandall, Marie

doi:10.1097/ta.0000000000001828

Cited by 26 publications

(11 citation statements)

References 42 publications

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“…6 In the past, states with stricter laws regarding youth recreational vehicles have had lower rates of pediatric injury and mortality. 1,40,41 For example, legislation passed in 2010 in Massachusetts required supervision of child riders, expanded helmet requirements, and mandated training classes for teen riders. Since implementation of this law, Massachusetts has observed sustained decreases in the rates of ED visits and inpatient hospitalizations, including a 50% reduction ED visits among 10-to 13-year-old patients.…”

Section: Discussionmentioning

confidence: 99%

The impact of helmet use on neurosurgical care and outcomes after pediatric all-terrain vehicle and dirt bike crashes: a 10-year single-center experience

Allen

Yengo‐Kahn²,

Vittetoe

et al. 2022

Journal of Neurosurgery: Pediatrics

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OBJECTIVE All-terrain vehicle (ATV) and dirt bike crashes frequently result in traumatic brain injury. The authors performed a retrospective study to evaluate the role of helmets in the neurosurgical outcomes of pediatric patients involved in ATV and dirt bike crashes who were treated at their institution during the last decade. METHODS The authors analyzed data on all pediatric patients involved in ATV or dirt bike crashes who were evaluated at a single regional level I pediatric trauma center between 2010 and 2019. Patients were excluded if the crash occurred in a competition (n = 70) or if helmet status could not be determined (n = 18). Multivariable logistic regression was used to analyze the association of helmet status with the primary outcomes of 1) neurosurgical consultation, 2) intracranial injury (including skull fracture), and 3) moderate or severe traumatic brain injury (MSTBI) and to control for literature-based, potentially confounding variables. RESULTS In total, 680 patients were included (230 [34%] helmeted patients and 450 [66%] unhelmeted patients). Helmeted patients were more frequently male (81% vs 66%). Drivers were more frequently helmeted (44.3%) than passengers (10.5%, p < 0.001). Head imaging was performed to evaluate 70.9% of unhelmeted patients and 48.3% of helmeted patients (p < 0.001). MSTBI (8.0% vs 1.7%, p = 0.001) and neurosurgical consultation (26.2% vs 9.1%, p < 0.001) were more frequent among unhelmeted patients. Neurosurgical injuries, including intracranial hemorrhage (16% vs 4%, p < 0.001) and skull fracture (18% vs 4%, p < 0.001), were more common in unhelmeted patients. Neurosurgical procedures were required by 2.7% of unhelmeted patients. One helmeted patient (0.4%) required placement of an intracranial pressure monitor, and no other helmeted patients required neurosurgical procedures. After adjustment for age, sex, driver status, vehicle type, and injury mechanism, helmet use significantly reduced the odds of neurosurgical consultation (OR 0.250, 95% CI 0.140–0.447, p < 0.001), intracranial injury (OR 0.172, 95% CI 0.087–0.337, p < 0.001), and MSTBI (OR 0.244, 95% CI 0.079–0.758, p = 0.015). The unadjusted absolute risk reduction provided by helmet use equated to a number-needed-to-helmet of 6 riders to prevent 1 neurosurgical consultation, 4 riders to prevent 1 intracranial injury, and 16 riders to prevent 1 MSTBI. CONCLUSIONS Helmet use remains problematically low among young ATV and dirt bike riders, especially passengers. Expanding helmet use among these children could significantly reduce the rates of intracranial injury and MSTBI, as well as the subsequent need for neurosurgical procedures. Promoting helmet use among recreational ATV and dirt bike riders must remain a priority for neurosurgeons, public health officials, and injury prevention professionals.

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Section: Discussionmentioning

confidence: 99%

The impact of helmet use on neurosurgical care and outcomes after pediatric all-terrain vehicle and dirt bike crashes: a 10-year single-center experience

Allen

Yengo‐Kahn²,

Vittetoe

et al. 2022

Journal of Neurosurgery: Pediatrics

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“…The EAST study group recommends ATV helmet use for all to reduce TBI, and implementing ATV safety legislation to reduce ATV injuries, noting that enforcement must go hand-in-hand with enactment to ensure compliance. 1 Many ATV riders are intoxicated and riding without helmets. In an ATV study from Charlotte, North Carolina, helmeted patients had lower Injury Severity Scores, lower intensive care unit (ICU) admission rates, and shorter ICU and hospital length of stay (LOS) (P < .05).…”

Section: Discussionmentioning

confidence: 99%

“…Death, disability, and trauma center admissions from ATV crashes have persisted nationwide in recent years. 1 Trauma centers in Tennessee frequently see ATV riders injured in other states with variable ATV helmet safety laws that are poorly enforced, with few wearing a helmet and many intoxicated.…”

Section: Introductionmentioning

confidence: 99%

Trauma Surgeon-Led and Funded Injury Prevention Program Decreases Number of All-Terrain Vehicle-Related Admissions

Holt

Fortmann

Testerman

2022

The American Surgeon™

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Background All-terrain vehicle (ATV) laws regarding helmet use, alcohol involvement, and roadway riding are poorly enforced or largely ignored. We hypothesized that direct surgeon funding and leadership in injury prevention would decrease ATV crashes. To focus prevention efforts, we reviewed a rural level 1 trauma center 11-year experience with ATV crashes comparing helmeted and unhelmeted rider outcomes. Methods For the latter 6 years of the study period, a trauma surgeon sponsored an injury prevention fund promoting ATV safety using simulators and discussions for area high school students. Helmet use, alcohol avoidance, and safe ATV operating were emphasized. A trauma registry review of ATV admissions from 2009 through 2020 examined demographics, helmet use, and clinical outcomes using chi-square, t-test, and regression analysis. Results Unhelmeted ATV riders suffered more severe head and neck injuries (OR 19, CI 1.5-1.8, P < .001), worse overall Injury Severity Score (ISS), (OR 25, CI 12.1-14.2, P < .001), and higher mortality rates (OR 4.0, CI .02-.05, P < .001). Helmet use corresponded with an average decrease in AIS and increase in GCS status. Although only 15% of riders were helmeted, ATV crash admissions have decreased in the last 5 years ( P < .001). Discussion All-terrain vehicle trauma and mortality is still frequent, especially in unhelmeted riders. The recent decrease in area ATV crashes is encouraging. Trauma surgeons have an opportunity to make a difference in public awareness and education through comprehensive physician-funded and directed injury prevention and research efforts.

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“…A comprehensive search for systematic reviews on quad bike injuries, by the authors, resulted in only one review, which have been carried out in 2018. 9 However, the review focused only on helmet use among quad bike users and did not provide an exhaustive list of other risk factors.…”

Section: Introductionmentioning

confidence: 99%

Risk factors associated with quad bike crashes: a protocol for systematic review of observational studies

et al. 2021

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IntroductionQuad bikes are four-wheeled vehicles, driven off-road on uneven terrains by farmers for work or young adults for leisure. Quad bike accidental crashes result mostly due to the unique ecosystem of uneven terrain, where these unstable vehicles are commonly driven, in addition to numerous distinctive sociodemographic characteristics related to drivers. This is a protocol for a systematic review of observational studies from all geographical regions and demographic groups in the world to summarise the common risk factors relating to quad bike crashes.Methods and analysisA comprehensive search for the literature on quad bike crashes and related injuries will be conducted in six electronic databases: PubMed, Embase, Scopus, Web of Science, IEEE and PsycINFO. Proquest Dissertation and Thesis, OpenGrey and BASE will be searched for grey literature. Five researchers will be involved in the screening, and the review of full text articles, using the inclusion and exclusion criteria. Disagreements between reviewers will be resolved by discourse. Three researchers will help resolving conflicts that may arise during the screening process and will resolve eventual conflicts identified in the process with the help of the systematic review software ’Covidence’ for automatic deduplication and blinded screening. Information on crashes leading to injuries and death, target population characteristics and risk factors involved will be extracted from eligible articles in addition to the assessment of the quality of the researched articles.Ethics and disseminationSince this is a systematic review of published literature, a formal ethical approval is not needed. Results of the review will be disseminated through peer-reviewed publications, conference presentations and reports to the concerned authorities.PROSPERO registration numberCRD42020170245.

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Prevention of all-terrain vehicle injuries: A systematic review from The Eastern Association for the Surgery of Trauma

Cited by 26 publications

References 42 publications

The impact of helmet use on neurosurgical care and outcomes after pediatric all-terrain vehicle and dirt bike crashes: a 10-year single-center experience

The impact of helmet use on neurosurgical care and outcomes after pediatric all-terrain vehicle and dirt bike crashes: a 10-year single-center experience

Trauma Surgeon-Led and Funded Injury Prevention Program Decreases Number of All-Terrain Vehicle-Related Admissions

Risk factors associated with quad bike crashes: a protocol for systematic review of observational studies

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