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Published on: January 12, 2019
Morbidity and mortality of children following motor vehicle crashes
Errington C Thompson1, Paul Perkowski, David Villarreal
1Division of Trauma, the Department of Surgery, Louisiana State University Health Science Center School of Medicine in Shreveport, USA. ecthompson@msn.com
Insights
Passenger restraint use was low in pediatric motor vehicle crash patients, and no survival benefit was observed. Further research is needed to understand why safety measures did not decrease pediatric deaths.
Area of Science:
- Traumatology
- Pediatric Emergency Medicine
- Public Health
Background:
- Motor vehicle crashes remain a leading cause of death and injury in children.
- The effectiveness of passenger compartment safety measures, including seat belts, in reducing pediatric morbidity and mortality requires ongoing evaluation.
Purpose of the Study:
- To evaluate the impact of passenger compartment safety measures on pediatric morbidity and mortality in motor vehicle crash victims.
- To assess the rate of restraint use among pediatric patients involved in motor vehicle crashes at a tertiary care trauma center.
Main Methods:
- Retrospective review of pediatric patients (<16 years) admitted to a Level I trauma center following motor vehicle crashes between July 1991 and December 2000.
- Analysis of intensive care complications, postoperative complications, and mortality.
- Comparison of restraint use in the study cohort with national pediatric data.
Main Results:
- A total of 191 pediatric patients were included in the study.
- Eight deaths occurred, with only one patient utilizing restraints.
- Restraint use in the study population (20%) was significantly lower than in the general US pediatric population (68%).
Conclusions:
- Death was infrequent among pediatric motor vehicle crash patients, with all fatalities occurring in extremis.
- No deaths were attributed to complications; however, a survival benefit from seat belt use was not detected.
- The low rate of seat belt use and the lack of observed survival benefit warrant further investigation.
Hypothesis:
The use of passenger compartment safety measures has not led to decreases in pediatric morbidity or mortality in our population of patients.
Design:
Retrospective review.
Setting:
University, tertiary care, level I trauma center.
Patients:
All patients admitted to the Trauma Center at Louisiana State University Health Science Center School of Medicine in Shreveport between July 1, 1991, and December 31, 2000, who were younger than 16 years and involved in a motor vehicle crash.
Main Outcome Measures:
Intensive care complications, postoperative complications, and mortality.
Results:
We reviewed the experience of all pediatric patients involved in motor vehicle crashes and transported to the Trauma Center at Louisiana State University Health Science Center School of Medicine in Shreveport from July 1, 1991, through December 31, 2000. A total of 191 patients met these criteria. There were 8 deaths, and only 1 of these patients was restrained. There were significantly more injuries in those patients who died compared with those who survived (Modified Injury Severity Score, 29 vs 9; P<.001). We compared the use of restraints in our cohort with the use of restraints in the US pediatric population. Only 20% of our patients were restrained vs 68% of the general pediatric population. This difference was significant (P<.001, chi2) test).
Conclusions:
In our population of patients, death was a relatively infrequent occurrence. All patients who died presented in extremis. No patient died as the result of a complication. The rate of seat belt use in our population of patients was low. The exact reason for why we were unable to detect any survival benefit with seat belt use is unclear and demands further investigation.
