title: Ten years of all-terrain vehicle injury, mortality, and healthcare costs.
abstract: BACKGROUND
  All-terrain vehicles (ATVs) are increasing in popularity worldwide. The province of Alberta accounts for 25% of Canadian ATV sales. This study describes the epidemiology, outcomes, and associated healthcare costs for a decade of ATV traumatic injury incidents.
  
  
  METHODS
  This is a retrospective population based cohort study using two provincial databases: the Alberta Trauma Registry and the Office of the Chief Medical Examiner of Alberta. Data for individuals aged 18 years or older with Injury Severity Score ≥ 12 or deaths between April 1, 1998, and March 31, 2008 were included. Healthcare costs were extrapolated using figures from a Level I trauma center.
  
  
  RESULTS
  ATV incidents resulted in 459 serious trauma cases, 395 trauma center admissions (a total of 4,117 days), and a 17% mortality rate. Postdischarge care was required for nearly 30% of patients. Male patients aged 18 years to 19 years had the highest incidence (6.5 of 100,000 people). Head, neck, and cervical spine injuries were most common (59%) and predictive of mortality (relative risk [RR], 2.19; interquartile range [IQR], 1.35-3.54; p = 0.001). Vehicle rollovers (RR, 2.75; IQR, 1.13-6.70; p = 0.01), vehicle ejection (RR, 4.18; IQR, 1.70-10.32; p = 0.000), alcohol intake (RR, 2.33; IQR, 1.52-3.56; p = 0.000), helmet use (RR, 1.82; IQR, 1.11-3.02; p = 0.01), and incident location were predictive of mortality.
  
  
  CONCLUSIONS
  Increasing rates of ATV-related serious trauma and death are described in young males riding without helmets after consuming alcohol. Serious injuries contributed to healthcare costs in excess of $6.5 million USD. Predictors of mortality include rider behaviors and mechanical factors. Prevention should include rider education and industry measures to improve ATV stability.
authors.affiliation: Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Emily Marie
authors.initials: EM
authors.lastname: Krauss
authors.forename: Dianne M
authors.initials: DM
authors.lastname: Dyer
authors.forename: Kevin B
authors.initials: KB
authors.lastname: Laupland
authors.forename: Richard
authors.initials: R
authors.lastname: Buckley
mesh_terms: D000063:Accidents, Traffic / Q000191:economics* / Q000401:mortality* / Q000706:statistics & numerical data*; D000328:Adult; D000416:Alberta / Q000453:epidemiology; D005260:Female; D006260:Head Protective Devices / Q000706:statistics & numerical data; D017048:Health Care Costs; D006801:Humans; D015994:Incidence; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D015541:Off-Road Motor Vehicles; D012042:Registries; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D014193:Trauma Centers