All-terrain vehicle related urethral injuries: An evaluation of the National Trauma Database

U.S. Consumer Product Safety Commission reported that from 2018 to 2020 there were 94,700 off-highway vehicle accidents with 92% of those injuries related to all-terrain vehicles (ATV). An estimated 300 deaths were in children less than age 16. There has not been any previous evaluation of urethral injuries resulting from ATV accidents. We sought to define the volume and demographics of ATV-related urethral injuries.

Data was obtained from the National Trauma Database (NTDB) Trauma Quality Program over a 7-year period (2016-2022). ICD-10 codes were used to identify patients who sustained urethral injury in ATV-related accidents. Injury and patient related demographic data was reviewed. R: A Language and Environment for Statistical Computing was used for data review and statistical analysis. Data were presented and analyzed using standard statistical methods RESULTS: During this time frame, there was a total of 7679,101 injuries recorded in the NTDB. There was a total of 7398 urethral injuries (0.1%), with 181 (2.5%) of those being related to ATV-accidents. 90.6% of patients were male, and there was a median age of 30 (range 5-76, IQR 29). The median injury severity score (ISS) was 17 (range 4-50, IQR 15). There was no association between age and higher ISS (r = 0.07, p = 0.36). Passengers were more likely to be less than age 16 (p = 0.001). Interestingly, 17% (26/153) of drivers were less than age 16. Non-traffic ATV accidents were associated with higher ISS (medians 21.5 versus 17, p = 0.003).

Urethral injuries are uncommon, however over 2% of these are related to ATV accidents alone. A high proportion of these injuries are severe, involving young patients, speaking to significant potential long-term morbidity.