Motorcycle-related injuries: effect of age on type and severity of injuries and mortality.
BACKGROUND
The aim of this study was to evaluate the relationship of age to the injury types, distribution, and severity in motorcycle crash (MCC) victims admitted to Los Angeles County emergency hospitals in California.


METHODS
This Los Angeles countywide trauma registry study included all MCC victims admitted to the 13 trauma centers of the Los Angeles County between January 1995 and December 2007. Besides demographical data collected, the Injury Severity Score, body area (head, chest, abdomen, and extremities), Abbreviated Injury Scale score >or=3, specific organ injuries, and mortality were calculated according to age groups (<or=18 years, 19-55 years, and >55 years). A stepwise logistic regression model was used to identify independent risk factors for death.


RESULTS
Among 6,530 admissions due to MCCs, there were 493 patients (7.5%) aged 18 years or younger, 5,627 patients (86%) aged 19 years to 55 years, and 398 patients (6.5%) older than 55 years. The incidences of severe injury (Injury Severity Score >15) in the three ascending age groups were 23.5%, 30.3%, and 36.2%, respectively (p < 0.05), and critical injuries (Injury Severity Score >25) occurred in 6.5%, 12.3%, and 13.8%, respectively (p < 0.05). Severe head injuries were significantly more likely in the population older than 55 year (odds ratio [OR] {95% confidence interval [CI] } = 1.45 {1.03-2.03}, p = 0.04). The risk of sustaining a severe chest injury (Abbreviated Injury Scale Chest Score >or=3) increased in a stepwise fashion with increasing age, with an OR (95% CI) = 1.86 (1.44-2.39) in the age group 19 years to 55 years and 2.81 (2.03-3.88) in the older than 55 years group, p < 0.001. Mortality was twofold higher in the 19-year- to 55-year-old group [OR (95% CI) = 2.30 (1.08-4.93), p = 0.03] and threefold higher in the older than 55 years group [OR (95% CI) = 3.28 (1.36-7.93), p = 0.05] compared with the <or=18-year-old group.


CONCLUSIONS
Injuries related to MCCs show age-related injury distribution, severity, and mortality rates. Older patients are significantly more likely to suffer severe trauma, severe head and chest injuries, and spinal fractures. Adaptation of trauma team activation criteria and more aggressive triage of older victims of motorcycle trauma should be considered.
Division of Acute Care Surgery (Trauma, Emergency Surgery, Surgical Critical Care), Department of Surgery, University of Southern California, Los Angeles, California 90033, USA. peep.talving@surgery.usc.edu
Peep
P
Talving
Pedro G R
PG
Teixeira
Galinos
G
Barmparas
Joseph
J
Dubose
Christy
C
Preston
Kenji
K
Inaba
Demetrios
D
Demetriades
D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D050723:Fractures, Bone / Q000453:epidemiology; D016489:Head Injuries, Closed / Q000453:epidemiology; D006801:Humans; D008099:Liver / Q000293:injuries; D015141:Los Angeles / Q000453:epidemiology; D008875:Middle Aged; D009049:Motorcycles; D012042:Registries; D012044:Regression Analysis; D013154:Spleen / Q000293:injuries; D014949:Wounds, Nonpenetrating / Q000453:epidemiology* / Q000401:mortality; D055815:Young Adult