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Evaluating pediatric car safety compliance in motor vehicle collisions: Identifying high-risk groups for improper
Claudio B Ghetti1, Alexandra S Rooney2, Víctor de Cos1
1University of California, San Diego School of Medicine, San Diego, CA, United States.
Insights
Hispanic children and those in disadvantaged neighborhoods are less likely to use proper restraints during motor vehicle collisions (MVCs). Targeted injury prevention programs are needed for these high-risk groups.
Area of Science:
- Pediatric Trauma Research
- Injury Prevention
- Public Health
Background:
- Motor vehicle collisions (MVCs) are a leading cause of injury in children.
- Proper restraint use is critical for mitigating pediatric trauma severity.
- Socioeconomic factors may influence adherence to safety guidelines.
Purpose of the Study:
- To identify patient factors linked to improper restraint usage in pediatric MVCs.
- To examine the association between neighborhood socioeconomic disadvantage and restraint practices.
- To determine if restraint non-usage correlates with worse trauma outcomes.
Main Methods:
- Retrospective study of pediatric patients (≤18 years) involved in MVCs (2008-2018).
- Area Deprivation Index (ADI) used to quantify neighborhood socioeconomic disadvantage (NSD).
- Analysis of restraint usage, demographics, and clinical outcomes correlated with ADI, race, and ethnicity.
Main Results:
- Hispanic children were overrepresented in areas with the greatest NSD (ADI quintile 5).
- Hispanic children under 8 years were less likely to use car/booster seats (OR 0.69).
- Children in areas with the greatest NSD had the highest proportion of unrestrained patients (21%).
Conclusions:
- Poorer restraint practices were observed in Hispanic children and those in socioeconomically disadvantaged areas.
- The Area Deprivation Index (ADI) effectively identifies high-risk populations for injury prevention.
- Targeted interventions are recommended to improve restraint compliance among vulnerable children.
Purpose:
To identify patient factors associated with improper restraint usage and worse trauma outcomes for pediatric patients involved in motor vehicle collisions (MVCs).
Methods:
Retrospective study performed at a Level I pediatric trauma center for patients (≤18 yr) evaluated after MVC between 2008 and 2018. The Area Deprivation Index (ADI) was used to measure neighborhood socioeconomic disadvantage (NSD) levels based on the patient's home address. Trauma registry data was correlated to ADI and used to analyze appropriate restraint usage by NSD. Proper restraint practices were defined based on national guidelines and state laws. Demographics and clinical outcomes were also analyzed. Chi-square analysis with Bonferroni corrections was used to assess the association of ADI, race, and ethnicity with proper restraint usage.
Results:
Among 1152 patients included, approximately 50% were male, the median age was 7 years [IQR 4-10], and 53% were of Hispanic ethnicity. Hispanic patients comprised 73% of children in ADI quintile 5 (greatest NSD), yet only 26% of children in ADI quintile 1 (least NSD). No differences were observed across clinical data and outcomes. Hispanic children <8 yr were significantly less likely to be in a car seat/booster seat compared to non-Hispanic children (OR 0.69, 95% CI 0.50-0.95, p = 0.025). Furthermore, those with greatest NSD (ADI quintile 5) had the largest proportion of unrestrained patients (21%, see Fig. 1).
Conclusion:
Hispanic children, especially those who require infant or booster seats (<8 yr), and children living in areas with greater neighborhood socioeconomic disadvantage demonstrated poorer restraint practices. ADI can successfully identify high-risk groups for targeted injury prevention programs and improved compliance in the most vulnerable neighborhoods.
Type Of Study:
Retrospective Study.
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