Milken Institute School of Public Health Poster Presentations (Marvin Center & Video)

Title

Teenage All-Terrain Vehicle Crashes: Helmet Non-compliance and Traumatic Brain Injury

Poster Number

109

Document Type

Poster

Status

Graduate Student - Masters

Abstract Category

Prevention and Community Health

Keywords

All-Terrain Vehicle Crashes, Pediatric Injury, Traumatic Brain Injury, Helmet use

Publication Date

Spring 2018

Abstract

Background: All-terrain vehicle (ATV) crashes are a source of childhood injury, especially traumatic brain injury (TBI). Children have differing influences on behavior at different ages; age-group assessment of safety practices is important in designing prevention programs. Helmet use is one of the proven injury prevention practices for ATV drivers. The primary objective was to identify which age groups had the highest odds for traumatic brain injury and exhibited lack of helmet wearing practices, to target a group for health prevention education.

Methods: After IRB approval, a retrospective cohort study of medical records at a level one trauma center was completed for years 1998-2012. Variables included presence of TBI, helmet use, crash month, and age. Chi-square analysis was used for categorical variables. Cases categorized into age groups corresponding to school levels. SPSS version 25 was used for analysis.

Results: 349 out of a total 750 were younger than 18 years. Cases/age group: 65 ages 0-10, 90 ages 11-13, 194 ages 14-18. Peak admission months were: 11-13-year-olds in September (15), August (11) and January (10); 14-18-year-olds in July (24).

190 had TBI, age categories: 27(41%) of 0-10 years, 51(56%) of 11-13 years, 112(57%) of 14-18 years. Comparing proportions in age groups of those with TBI, the 14-18-year-old group had the highest percentage at 58.9% (p, .068). 349 had helmet data, 17% used helmets. Eighteen (11%) persons out of the 163 with acute brain injury were wearing a helmet, 145 (89.0%) were unhelmeted (p=.004). Relative risk of unhelmeted patients for TBI was 1.6. Odds ratio for unhelmeted to have TBI compared to helmeted was 2.656, p, .004. Relative risk of TBI for unhelmeted compared to helmeted to have TBI in the 0-10, 11-13, 14-18 age groups respectively was 1.5 (p=0.47), 2.7 (p=.21), 1.75(p=.009).

Conclusion: Overall odds ratio for unhelmeted children admitted after ATV crash was significantly higher than for helmeted crash victims. OR for TBI was significantly elevated in unhelmeted 14-18-year-old ATV crash victims admitted to the hospital, the largest age group category with the highest proportion of TBI. Since July had the highest incidence of TBI, the 14-18 year-old group should be targeted prior to July for a helmet-wearing ATV safety education intervention.

Age group

N (%)

Helmet (%)

Unhelmeted (%)

TBI (%)

OR of TBI/unhelmeted

P (1.)

0-10

65 (18.6)

9 (16.4%)

46 (83.6%)

27 (41.5%)

2.0

0..48

11-13

90 (25.8)

12 (15.8%)

64 (84.2%)

51 (56.7%)

2.33

0.21

14-18

194 (55.6)

27 (17.6%)

126 (82.4%)

112 (57.7%)

3.17

.009

total

349 (100)

48 (13.8)

236 (67.6)

190 (54.4%)

2.656

.004 *

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Teenage All-Terrain Vehicle Crashes: Helmet Non-compliance and Traumatic Brain Injury

Background: All-terrain vehicle (ATV) crashes are a source of childhood injury, especially traumatic brain injury (TBI). Children have differing influences on behavior at different ages; age-group assessment of safety practices is important in designing prevention programs. Helmet use is one of the proven injury prevention practices for ATV drivers. The primary objective was to identify which age groups had the highest odds for traumatic brain injury and exhibited lack of helmet wearing practices, to target a group for health prevention education.

Methods: After IRB approval, a retrospective cohort study of medical records at a level one trauma center was completed for years 1998-2012. Variables included presence of TBI, helmet use, crash month, and age. Chi-square analysis was used for categorical variables. Cases categorized into age groups corresponding to school levels. SPSS version 25 was used for analysis.

Results: 349 out of a total 750 were younger than 18 years. Cases/age group: 65 ages 0-10, 90 ages 11-13, 194 ages 14-18. Peak admission months were: 11-13-year-olds in September (15), August (11) and January (10); 14-18-year-olds in July (24).

190 had TBI, age categories: 27(41%) of 0-10 years, 51(56%) of 11-13 years, 112(57%) of 14-18 years. Comparing proportions in age groups of those with TBI, the 14-18-year-old group had the highest percentage at 58.9% (p, .068). 349 had helmet data, 17% used helmets. Eighteen (11%) persons out of the 163 with acute brain injury were wearing a helmet, 145 (89.0%) were unhelmeted (p=.004). Relative risk of unhelmeted patients for TBI was 1.6. Odds ratio for unhelmeted to have TBI compared to helmeted was 2.656, p, .004. Relative risk of TBI for unhelmeted compared to helmeted to have TBI in the 0-10, 11-13, 14-18 age groups respectively was 1.5 (p=0.47), 2.7 (p=.21), 1.75(p=.009).

Conclusion: Overall odds ratio for unhelmeted children admitted after ATV crash was significantly higher than for helmeted crash victims. OR for TBI was significantly elevated in unhelmeted 14-18-year-old ATV crash victims admitted to the hospital, the largest age group category with the highest proportion of TBI. Since July had the highest incidence of TBI, the 14-18 year-old group should be targeted prior to July for a helmet-wearing ATV safety education intervention.

Age group

N (%)

Helmet (%)

Unhelmeted (%)

TBI (%)

OR of TBI/unhelmeted

P (1.)

0-10

65 (18.6)

9 (16.4%)

46 (83.6%)

27 (41.5%)

2.0

0..48

11-13

90 (25.8)

12 (15.8%)

64 (84.2%)

51 (56.7%)

2.33

0.21

14-18

194 (55.6)

27 (17.6%)

126 (82.4%)

112 (57.7%)

3.17

.009

total

349 (100)

48 (13.8)

236 (67.6)

190 (54.4%)

2.656

.004 *