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Spinal injury in motor vehicle crashes: elevated risk persists up to 12 years of age
1Prince of Wales Medical Research Institute, University of New South Wales, Sydney, Australia. Julie.Brown@unsw.edu.au
Insights
Children under 12 years old face a higher risk of serious spinal injuries in motor vehicle crashes. This finding highlights potential issues with seat belt fit for younger children.
Area of Science:
- Pediatric Trauma
- Spinal Injury Biomechanics
- Motor Vehicle Safety
Background:
- Serious spinal injuries are a significant concern in pediatric motor vehicle occupants.
- Understanding age-related risk factors is crucial for injury prevention and management.
Purpose of the Study:
- To investigate the association between age and serious spinal injury in children involved in motor vehicle crashes.
- To control for crash-related factors in assessing this association.
Main Methods:
- Retrospective record review of pediatric motor vehicle occupants treated at two children's hospitals (1999-2004).
- Inclusion criteria: ages 0-16 years with ICD-10 codes for spinal trauma.
- Injury outcomes classified as minor (AIS 1) or serious (risk to spinal integrity).
Main Results:
- 72 cases identified; 58 were under 12 years old.
- Logistic regression analysis, adjusting for crash severity and type, revealed a significant association.
- Children under 12 were more likely to sustain serious spinal injury (Odds Ratio 7.1, 95% CI 1.2-42.9) compared to older children.
Conclusions:
- Children up to age 12 are at an elevated risk for serious spinal injury in car crashes.
- Inadequate seat belt fit for younger children may contribute to this increased risk.
- Age should be considered in the triage and management of pediatric motor vehicle crash occupants.
Objective:
To determine whether age is associated with serious spinal injury in paediatric motor vehicle occupants, after controlling for crash-related factors.
Design And Setting:
Retrospective record review.
Patients And Outcome Measures:
All motor vehicle passengers aged 0-16 years treated at two major children's hospitals from 1999 to 2004 with ICD-10 codes for spinal trauma. Injury outcomes were categorised as minor and serious. Minor injuries were analogous to AIS 1 injuries. Serious injuries were those that posed some risk to the integrity of the spinal column or cord.
Results:
72 cases were identified (58 <12 years of age, 14 > or = 12 years of age). Using logistic regression to adjust for confounders, including crash severity and crash type, age <12 years was found to be significantly associated with serious spinal injury. Compared to older children, children aged less than 12 years were more likely to sustain serious spinal injury (OR 7.1, 95% CI 1.2 to 42.9).
Conclusion:
Children up to age 12 have an elevated risk of serious spinal injury in car crashes. This age breakpoint may reflect the adequacy of seat belt fit, and use of adult seatbelts alone before age 12 may increase a child's risk of serious spinal injury. An association between age and serious spinal injury should also be considered in the triage of paediatric motor vehicle occupants.
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