C. A. Butts1, R. Gonzalez1, L. Nguyen1, J. P. Gaughan1, S. Ross1, J. Porter1, J. P. Hazelton1 1Cooper University Hospital,Trauma, Surgical Critical Care, & Acute Care Surgery,Camden, NEW JERSEY, USA
Introduction: Traditionally, all-terrain vehicles (ATV) and dirt bikes (DB) have been used in rural locations for recreation and work. Recently, there has been an increase in the use of these vehicles in an urban environment. The aim of this study is to compare the injury patterns of patients involved in crashes while riding recreational vehicles in both an urban (URV) and rural (RRV) environment.
Methods: A retrospective review (2005-2016) of patients who presented to an urban Level I trauma center as a result of any ATV or DB crash was performed. URV was defined as any ATV or DB accident which occurred on paved inner city, suburban or major roadways. RRV was defined as those accidents which occurred on secondary roadways or off-road. Patients who presented more than 48 hours from time of accident were excluded. A p<0.05 was considered significant.
Results: 528 patients were identified to have an ATV or DB injury [RRV n=296 (56%); URV n=232 (44%)]. Patients involved in URV accidents had a higher ISS (12.2 vs 9.7; p<0.05), lower presenting GCS (13.8 vs 14.3; p<0.05), and were more likely to need emergent procedures (ie: intubation, central line, tube thoracostomy) in the trauma bay (28.5% vs. 17.9%; p=0.005). URV patients were less likely to have been helmeted (39.6% vs 71.2%; p <0.001), and more likely to have traumatic brain injuries (35.8% vs 27.7%; p = 0.058), or extremity injuries (53.5% vs 41.2%; p=0.006). Additional injury patterns for the two groups were as follows: [face (18.1% vs 12.5%, p=0.09); spine (18.1% vs 19.6%, p=0.74); thoracic (34.9% vs 34.1%, p=0.85); abdomen (14.2% vs 16.9%, p=0.47); pelvis (7.8% vs 6.4%, p=0.61). There was no difference in remaining hospital outcomes including mortality.
Conclusion: Our data suggests that URV use was associated with decreased helmet use, higher mean ISS, lower presenting GCS, an increased need for emergent trauma bay procedures, higher rates of traumatic brain injury, and higher rates of extremity injuries.