Rollover injuries in residential driveways: age-related patterns of injury.
BACKGROUND
The major objective of the present study was to determine the severity of nonfatal injuries sustained by children (<16 years old) when a motor vehicle rolls over them. We also sought to determine whether younger children (<24 months old) demonstrated different patterns of injury and/or a worse outcome, compared with older children (>24 months old).


METHODS
We reviewed the medical records of 3971 consecutive admissions to a single trauma service at an urban children's hospital between March 1990 and October 1994. During this time period, 26 (0.7%) children presented with rollover injuries incurred by motor vehicles in residential driveways. Outcome was measured by length of both intensive care unit admission and hospitalization.


RESULTS
Two children died shortly after admission and were excluded from the remainder of the study. Younger children (<24 months old) had significantly higher injury severity scores and lower pediatric trauma scale scores. Both the duration in the intensive care unit and the length of hospitalization were significantly longer in younger children, compared with children >24 months old. One explanation for these observations was that younger children had a significantly higher incidence of both head and neck and extremity injury but a similar incidence and severity of chest and abdominal trauma, compared with older children. Injuries requiring operative intervention were rare.


CONCLUSIONS
Younger patients sustaining rollover injuries in the residential driveway have a worse outcome, in part, because of the head and neck or extremity injures that they incur. The majority of rollover injuries can be managed conservatively. pediatric trauma, driveway, pedestrian events, rollover injuries, injury severity score, pediatric trauma scale.
Silen
M L
ML
Division of Pediatric Surgery, Departments of Surgery and Pediatrics, Saint Louis University Health Sciences Center and Cardinal Glennon Children's Hospital, St Louis, Missouri 63104, USA. silenml@wpogate.slu.edu
Kokoska
E R
ER
Fendya
D G
DG
Kurkchubasche
A G
AG
Weber
T R
TR
Tracy
T F
TF
D000061:Accidents, Home / Q000706:statistics & numerical data; D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D017677:Age Distribution; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D015601:Injury Severity Score; D015278:Intensive Care Units, Pediatric; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008923:Missouri / Q000453:epidemiology; D009104:Multiple Trauma / Q000145:classification / Q000453:epidemiology; D015599:Trauma Severity Indices; D014947:Wounds and Injuries / Q000145:classification* / Q000453:epidemiology