title: A Cross-Sectional Study of Emergency Department Visits by Children After All-Terrain Vehicle Crashes, Motor Vehicle Crashes, and Sports Activities.
abstract: OBJECTIVE
  All-terrain vehicle (ATV) crashes have been responsible for significant injuries among children, despite public education efforts. Our study examined pediatric ATV injury patterns in US emergency departments (EDs) compared with injuries after motor vehicle crash (MVC) and sports activities.
  
  
  METHODS
  We studied 2006 to 2011 data from the Nationwide Emergency Department Sample. Children younger than 18 years and involved in ATV crashes, MVC, or sports activities were included. The primary outcome analyzed was a constructed binary measure identifying severe trauma, defined as injury severity score greater than 15. Logistic regression models were fit to determine the association between mechanism of injury and severe trauma.
  
  
  RESULTS
  A total of 6,004,953 ED visits were identified. Of these, ATV crashes accounted for 3.4%, MVC accounted for 44.7%, and sports activities accounted for 51.9%. Emergency department visits after ATV crashes were more likely to result in admission (8%) and incur higher median charges ($1263) compared with visits after sports activities (1%, $1013). Visits after sports activities were 90% less likely to result in severe trauma when compared with ATV crash visits. Emergency department visits after ATV crashes result in severe injuries similar to those sustained in MVC (odds ratio, 1.03; P = 0.626).
  
  
  CONCLUSIONS
  Pediatric ED visits after ATV crashes result in significant injuries and charges. Public health interventions such as education, legislation, and engineering are needed to reduce injuries among children and the subsequent ED visits for care. The impact of proven interventions may be greatest for children living in rural areas and among older children, 10 to 17 years old.
authors.forename: Rosemary
authors.initials: R
authors.lastname: Nabaweesi
authors.forename: James M
authors.initials: JM
authors.lastname: Robbins
authors.forename: Anthony
authors.initials: A
authors.lastname: Goudie
authors.forename: Jennifer I
authors.initials: JI
authors.lastname: Onukwube
authors.affiliation: Department of Health Policy & Management, Faye W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR.
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Bowman
authors.forename: Mary E
authors.initials: ME
authors.lastname: Aitken
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000293:Adolescent; D001265:Athletic Injuries / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D015601:Injury Severity Score; D008297:Male; D015541:Off-Road Motor Vehicles / Q000706:statistics & numerical data; D012189:Retrospective Studies; D014481:United States; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000209:etiology