Driveway crush injuries in young children: a highly lethal, devastating, and potentially preventable event.
OBJECTIVE
The aim of this study was to investigate driveway-related injuries in children, identify associated risk factors, and evaluate outcome compared with other mechanisms of blunt trauma.


METHODS
A 6-year review (1991 to 1996) of pediatric (age less than 18 years) pedestrian injuries treated at two urban trauma centers was conducted: one regional pediatric trauma center and one level I trauma center with pediatric commitment. Five hundred twenty-seven children injured in pedestrian accidents were identified from the trauma registry; 51 children (10%) sustained traumatic injuries as a result of being struck in their driveway. Data are reported as mean +/- SEM.


RESULTS
Children less than 5 years of age (n = 41) had an injury severity score (ISS) of 12.3+/-2.3, 15 (37%) sustained closed head injury, 13 (37%) had torso trauma, 19 (46%) skeletal trauma, and eight (20%) died. Children > or = 5 years old (n = 10) had an ISS of 10.7+/-2.4, three (30%) sustained closed head injury, four (40%) torso trauma, six (60%) skeletal trauma, and none died. In contrast, all other pediatric pedestrian accidents analyzed over the same time period had a mortality rate of only 2% (11 of 476).


CONCLUSIONS
Pediatric driveway trauma carries a significant risk of head injury and a 10-fold increase in mortality in children under 5 years of age when compared with all other pediatric pedestrian accidents. More emphasis must be placed on injury prevention and public education to prevent this devastating mechanism of injury in these young, vulnerable children.
Partrick
D A
DA
Department of Surgery, The Children's Hospital, University of Colorado Health Sciences Center, Denver 80218, USA.
Bensard
D D
DD
Moore
E E
EE
Partington
M D
MD
Karrer
F M
FM
D000061:Accidents, Home / Q000401:mortality / Q000517:prevention & control* / Q000706:statistics & numerical data; D000063:Accidents, Traffic / Q000401:mortality / Q000517:prevention & control* / Q000706:statistics & numerical data; D017677:Age Distribution; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D015601:Injury Severity Score; D008297:Male; D012042:Registries; D012307:Risk Factors; D017678:Sex Distribution; D014193:Trauma Centers; D014481:United States / Q000453:epidemiology; D014949:Wounds, Nonpenetrating / Q000209:etiology / Q000401:mortality*