Does restraint status in motor vehicle crash with rollover predict the need for trauma team presence on arrival? An ATOMAC study

John Recicar, Amanda Barczyk, Sarah Duzinski, Karla A. Lawson, Nilda M. Garcia, Robert Letton, Alexander R. Raines, James Eubanks, Nima Azarakhsh, Sandra Grimes, David M. Notrica, Pamela Garcia-Fillon, Adam Alder, Cynthia Greenwell, Stephen Megison, Mallikarjuna Rettiganti, Chunqiao Luo, Robert Todd Maxson

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Purpose Restraint status has not been combined with mechanistic criteria for trauma team activation. This study aims to assess the relationship between motor vehicle crash rollover (MVC-R) mechanism with and without proper restraint and need for trauma team activation. Methods Patients < 16 years old involved in an MVC-R between November 2007 and November 2012 at 6 Level 1 pediatric trauma centers were included. Restraint status, the need for transfusion or intervention in the emergency department (ED), hospital and intensive care length of stay and mortality were assessed. Results Of 690 cases reviewed, 48% were improperly restrained. Improperly restrained children were more likely to require intubation (OR 10.24; 95% CI 2.42 to 91.69), receive blood in the ED (OR 4.06; 95% CI 1.43 to 14.17) and require intensive care (ICU) (OR; 3.11; 95% CI 1.96 to 4.93) than the properly restrained group. The improperly restrained group had a longer hospital length of stay (p < 0.001), and a higher mortality (3.4% vs. 0.8%; OR 4.09; 95% CI 1.07 to 23.02) than the properly restrained group. Conclusion Unrestrained children in MVC-R had higher injury severity and were significantly more likely to need urgent interventions compared to properly restrained children. This supports a modification to include restraint status with the rollover criterion for trauma team activation.

Original languageEnglish (US)
Pages (from-to)319-322
Number of pages4
JournalJournal of Pediatric Surgery
Volume51
Issue number2
DOIs
StatePublished - Feb 1 2016

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Motor Vehicles
Length of Stay
Wounds and Injuries
Critical Care
Hospital Emergency Service
Mortality
Trauma Centers
Emergency Medical Services
Intubation
Pediatrics

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pediatrics, Perinatology, and Child Health

Cite this

Does restraint status in motor vehicle crash with rollover predict the need for trauma team presence on arrival? An ATOMAC study. / Recicar, John; Barczyk, Amanda; Duzinski, Sarah; Lawson, Karla A.; Garcia, Nilda M.; Letton, Robert; Raines, Alexander R.; Eubanks, James; Azarakhsh, Nima; Grimes, Sandra; Notrica, David M.; Garcia-Fillon, Pamela; Alder, Adam; Greenwell, Cynthia; Megison, Stephen; Rettiganti, Mallikarjuna; Luo, Chunqiao; Maxson, Robert Todd.

In: Journal of Pediatric Surgery, Vol. 51, No. 2, 01.02.2016, p. 319-322.

Research output: Contribution to journalArticle

Recicar, J, Barczyk, A, Duzinski, S, Lawson, KA, Garcia, NM, Letton, R, Raines, AR, Eubanks, J, Azarakhsh, N, Grimes, S, Notrica, DM, Garcia-Fillon, P, Alder, A, Greenwell, C, Megison, S, Rettiganti, M, Luo, C & Maxson, RT 2016, 'Does restraint status in motor vehicle crash with rollover predict the need for trauma team presence on arrival? An ATOMAC study', Journal of Pediatric Surgery, vol. 51, no. 2, pp. 319-322. https://doi.org/10.1016/j.jpedsurg.2015.10.041
Recicar, John ; Barczyk, Amanda ; Duzinski, Sarah ; Lawson, Karla A. ; Garcia, Nilda M. ; Letton, Robert ; Raines, Alexander R. ; Eubanks, James ; Azarakhsh, Nima ; Grimes, Sandra ; Notrica, David M. ; Garcia-Fillon, Pamela ; Alder, Adam ; Greenwell, Cynthia ; Megison, Stephen ; Rettiganti, Mallikarjuna ; Luo, Chunqiao ; Maxson, Robert Todd. / Does restraint status in motor vehicle crash with rollover predict the need for trauma team presence on arrival? An ATOMAC study. In: Journal of Pediatric Surgery. 2016 ; Vol. 51, No. 2. pp. 319-322.
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abstract = "Purpose Restraint status has not been combined with mechanistic criteria for trauma team activation. This study aims to assess the relationship between motor vehicle crash rollover (MVC-R) mechanism with and without proper restraint and need for trauma team activation. Methods Patients < 16 years old involved in an MVC-R between November 2007 and November 2012 at 6 Level 1 pediatric trauma centers were included. Restraint status, the need for transfusion or intervention in the emergency department (ED), hospital and intensive care length of stay and mortality were assessed. Results Of 690 cases reviewed, 48{\%} were improperly restrained. Improperly restrained children were more likely to require intubation (OR 10.24; 95{\%} CI 2.42 to 91.69), receive blood in the ED (OR 4.06; 95{\%} CI 1.43 to 14.17) and require intensive care (ICU) (OR; 3.11; 95{\%} CI 1.96 to 4.93) than the properly restrained group. The improperly restrained group had a longer hospital length of stay (p < 0.001), and a higher mortality (3.4{\%} vs. 0.8{\%}; OR 4.09; 95{\%} CI 1.07 to 23.02) than the properly restrained group. Conclusion Unrestrained children in MVC-R had higher injury severity and were significantly more likely to need urgent interventions compared to properly restrained children. This supports a modification to include restraint status with the rollover criterion for trauma team activation.",
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AU - Recicar, John

AU - Barczyk, Amanda

AU - Duzinski, Sarah

AU - Lawson, Karla A.

AU - Garcia, Nilda M.

AU - Letton, Robert

AU - Raines, Alexander R.

AU - Eubanks, James

AU - Azarakhsh, Nima

AU - Grimes, Sandra

AU - Notrica, David M.

AU - Garcia-Fillon, Pamela

AU - Alder, Adam

AU - Greenwell, Cynthia

AU - Megison, Stephen

AU - Rettiganti, Mallikarjuna

AU - Luo, Chunqiao

AU - Maxson, Robert Todd

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Y1 - 2016/2/1

N2 - Purpose Restraint status has not been combined with mechanistic criteria for trauma team activation. This study aims to assess the relationship between motor vehicle crash rollover (MVC-R) mechanism with and without proper restraint and need for trauma team activation. Methods Patients < 16 years old involved in an MVC-R between November 2007 and November 2012 at 6 Level 1 pediatric trauma centers were included. Restraint status, the need for transfusion or intervention in the emergency department (ED), hospital and intensive care length of stay and mortality were assessed. Results Of 690 cases reviewed, 48% were improperly restrained. Improperly restrained children were more likely to require intubation (OR 10.24; 95% CI 2.42 to 91.69), receive blood in the ED (OR 4.06; 95% CI 1.43 to 14.17) and require intensive care (ICU) (OR; 3.11; 95% CI 1.96 to 4.93) than the properly restrained group. The improperly restrained group had a longer hospital length of stay (p < 0.001), and a higher mortality (3.4% vs. 0.8%; OR 4.09; 95% CI 1.07 to 23.02) than the properly restrained group. Conclusion Unrestrained children in MVC-R had higher injury severity and were significantly more likely to need urgent interventions compared to properly restrained children. This supports a modification to include restraint status with the rollover criterion for trauma team activation.

AB - Purpose Restraint status has not been combined with mechanistic criteria for trauma team activation. This study aims to assess the relationship between motor vehicle crash rollover (MVC-R) mechanism with and without proper restraint and need for trauma team activation. Methods Patients < 16 years old involved in an MVC-R between November 2007 and November 2012 at 6 Level 1 pediatric trauma centers were included. Restraint status, the need for transfusion or intervention in the emergency department (ED), hospital and intensive care length of stay and mortality were assessed. Results Of 690 cases reviewed, 48% were improperly restrained. Improperly restrained children were more likely to require intubation (OR 10.24; 95% CI 2.42 to 91.69), receive blood in the ED (OR 4.06; 95% CI 1.43 to 14.17) and require intensive care (ICU) (OR; 3.11; 95% CI 1.96 to 4.93) than the properly restrained group. The improperly restrained group had a longer hospital length of stay (p < 0.001), and a higher mortality (3.4% vs. 0.8%; OR 4.09; 95% CI 1.07 to 23.02) than the properly restrained group. Conclusion Unrestrained children in MVC-R had higher injury severity and were significantly more likely to need urgent interventions compared to properly restrained children. This supports a modification to include restraint status with the rollover criterion for trauma team activation.

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