title: Snowmobile injuries in children and adolescents.
abstract: OBJECTIVE
  To characterize the risk factors and patterns of injury for children involved in snowmobile incidents.
  
  
  METHODS
  We reviewed the medical records of patients younger than 18 years who required hospital admission for snowmobile-related incidents from 1992 to 2001. Information obtained from these records and from the trauma database included patient demographics, mechanism of injury, injury patterns, medical care, and outcomes.
  
  
  RESULTS
  Forty-three patients were admitted to our hospital for snowmobile-related incidents. Snowmobile incidents occurred most commonly in male adolescents. The 2 most common mechanisms of injury were ejection and striking a stationary object. Twenty-seven (63%) of the patients drove the snowmobile. Only 23 patients (53%) wore a helmet. At presentation, the mean +/- SEM Injury Severity Score (ISS) was 12.1 +/- 1.4. Orthopedic injuries predominated (n = 42); however, abdominal (n = 12) and head (n = 8) injuries were also common. Four patients were intubated, and 15 required intensive care unit admission. Twenty-nine patients (67%) required surgical intervention. The mean +/- SEM length of hospitalization was 6.7 +/- 1.4 days. No deaths occurred; however, 7 patients (16%) had long-term disabilities. A significant improvement occurred in both Glasgow Coma Scale (GCS) score and ISS for patients using a helmet. In addition, helmet use increased with age (P = .01). Days in the intensive care unit were proportional to both GCS score (r(s) = -0.47; P = .002) and ISS (r(s) = 0.6; P < .001). Length of hospitalization also correlated with both GCS score (r(s) = -0.03; P = .008) and ISS (r(s) = 0.54; P = .02).
  
  
  CONCLUSIONS
  Snowmobiles are a significant source of multitrauma for children. Orthopedic injuries predominate, especially in older children, and can lead to long-term disabilities. Helmet use significantly reduces injuries; however, vulnerable younger patients do not frequently wear helmets.
authors.affiliation: Division of Pediatric Surgery, Mayo Clinic College of Medicine, Rochester, Minn 55905, USA.
authors.forename: Ali
authors.initials: A
authors.lastname: Nayci
authors.forename: Penny L
authors.initials: PL
authors.lastname: Stavlo
authors.forename: Abdalla E
authors.initials: AE
authors.lastname: Zarroug
authors.forename: Scott P
authors.initials: SP
authors.lastname: Zietlow
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Moir
authors.forename: David A
authors.initials: DA
authors.lastname: Rodeberg
mesh_terms: D000063:Accidents, Traffic / Q000517:prevention & control / Q000706:statistics & numerical data* / Q000639:trends; D000293:Adolescent; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D005260:Female; D006260:Head Protective Devices; D006760:Hospitalization / Q000706:statistics & numerical data / Q000639:trends; D006801:Humans; D015994:Incidence; D008297:Male; D008910:Minnesota / Q000453:epidemiology; D009104:Multiple Trauma / Q000453:epidemiology* / Q000517:prevention & control; D015541:Off-Road Motor Vehicles / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D015599:Trauma Severity Indices