title: The hazards of off-road motor sports: Are four wheels better than two?
abstract: BACKGROUND
  Off-road motorsports are an increasing popular activity, yet the relative safety profile of all-terrain vehicles (ATV) to off-road motorcycles (ORMC) has not been compared.
  
  
  METHODS
  A retrospective review of the 2002-2006 US National Trauma Data Bank of ATV and ORMC crash victims. Patients were described according to demographic (age, sex, race and ethnicity, insurance status) and injury characteristics (Injury Severity Score, hypotension, motor component of the Glasgow Coma Score, presence of a severe head or extremity injury) known to affect trauma outcomes. Logistic regression evaluated the independent effect of an ATV vehicle on mortality, intensive care unit (ICU) admission, and placement on a ventilator relative to ORMC. The anatomic distribution of severe injuries was compared between survivors and decedents within each vehicle type.
  
  
  RESULTS
  A total of 34,457 patients met inclusion criteria, of whom, 24,582 were ATV patients and 9875 were ORMC patients. ATV patients had 51% higher risk-adjusted odds of death (OR 1.51; 95% CI 1.03-2.20), 55% higher risk-adjusted odds of being admitted to an ICU (OR 1.55; 95% CI 1.42-1.70), and 42% higher risk-adjusted odds of being placed on a ventilator (OR 1.42, 95% CI 1.17-1.72) compared to ORMC crash victims. Decedents in both vehicle types were more likely to suffer severe head, thoracic, and abdominal injuries relative to their surviving counterparts.
  
  
  CONCLUSIONS
  For injured riders, ATVs are associated with increased mortality and higher resource utilisation compared to ORMCs. Both groups suffer distinct anatomic injuries, suggesting the need for focused areas of injury prevention planning and research.
authors: Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors: Cassandra V
authors: CV
authors: Villegas
authors: Department of Health Policy & Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors: Stephen M
authors: SM
authors: Bowman
authors: Center for Surgery and Public Health, Harvard Medical School and Harvard T.H. Chan School of Public Health, Department of Surgery, Brigham & Women's Hospital, Boston, MA, USA.
authors: Cheryl K
authors: CK
authors: Zogg
authors: Center for Surgery and Public Health, Harvard Medical School and Harvard T.H. Chan School of Public Health, Department of Surgery, Brigham & Women's Hospital, Boston, MA, USA.
authors: Valerie K
authors: VK
authors: Scott
authors: Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors: Elliott R
authors: ER
authors: Haut
authors: Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors: Kent A
authors: KA
authors: Stevens
authors: Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors: David T
authors: DT
authors: Efron
authors: Center for Surgery and Public Health, Harvard Medical School and Harvard T.H. Chan School of Public Health, Department of Surgery, Brigham & Women's Hospital, Boston, MA, USA. Electronic address: ahhaider@partners.org.
authors: Adil H
authors: AH
authors: Haider
mesh_terms: D000056:Accident Prevention; D000063:Accidents, Traffic / Q000517:prevention & control* / Q000706:statistics & numerical data; D000367:Age Factors; D000704:Analysis of Variance; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015601:Injury Severity Score; D007902:Length of Stay / Q000706:statistics & numerical data; D009049:Motorcycles; D015541:Off-Road Motor Vehicles / Q000706:statistics & numerical data; D011482:Protective Devices / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D014193:Trauma Centers / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D014947:Wounds and Injuries / Q000453:epidemiology / Q000517:prevention & control*
keywords: All terrain vehicles; Injury prevention; Off-road motorcycles; Off-road motorsports; Trauma