Biomaterial Database

Geriatric All-Terrain Vehicle Trauma: An Unhelmeted and Severely Injured Population. 2022

Jenaya L Goldwag, and Eleah D Porter, and Allison R Wilcox, and Zhongze Li, and Tor D Tosteson ScD, and Andrew O Crockett, and Andrea B Wolffing, and D Joshua Mancini, and Eric D Martin, and John W Scott, and Alexandra Briggs

Department of Surgery, Dartmouth-Hitchcock Medical Center, 1 Medical Center Dr, Lebanon, NH, 03756.

All-terrain vehicle (ATV) use is widespread, however, little is known about injury patterns and outcomes in geriatric patients. We hypothesized that geriatric patients would have distinct and more severe injuries than non-geriatric adults after ATV trauma. A retrospective cohort study was performed using the National Trauma Databank comparing non-geriatric (18-64) and geriatric adults (≥65) presenting after ATV trauma at Level 1 and 2 trauma centers from 2011 to 2015. Demographic, admission, and outcomes data were collected, including injury severity score (ISS), abbreviated injury scale (AIS) score, discharge disposition, and mortality. We performed univariate statistical tests between cohorts and multiple logistic regression models to assess for risk factors associated with severe injury (ISS>15) and mortality. 23,568 ATV trauma patients were identified, of whom 1,954 (8.3%) were geriatric. Geriatric patients had higher rates of severe injury(29.2 v 22.5%,p<0.0001), and thoracic (55.2 v 37.8%,p<0.0001) and spine (31.5 v 26.0%,p<0.0001) injuries, but lower rates of abdominal injuries (14.6 v 17.9%,p<0.001) as compared to non-geriatric adults. Geriatric patients had overall lower head injury rates (39.2 v 42.1%,p=0.01), but more severe head injuries (AIS>3) (36.2 vs 30.2%,p<0.001). Helmet use was significantly lower in geriatric patients (12.0 v 22.8%,p<0.0001). On multivariate analysis age increased the odds for both severe injury (OR 1.50, 95% CI 1.31-1.72, p<0.0001) and mortality (OR 5.07, 95% CI 3.42-7.50, p<0.0001). While severe injury and mortality after ATV trauma occurred in all adults, geriatric adults suffered distinct injury patterns and were at greater risk for severe injury and mortality.

UI	MeSH Term	Description	Entries
D006260	Head Protective Devices	Personal devices for protection of heads from impact, penetration from falling and flying objects, and from limited electric shock and burn.	Helmets,Device, Head Protective,Devices, Head Protective,Head Protective Device,Helmet,Protective Device, Head,Protective Devices, Head
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328	Adult	A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available.	Adults
D000368	Aged	A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available.	Elderly
D012189	Retrospective Studies	Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.	Retrospective Study,Studies, Retrospective,Study, Retrospective
D014193	Trauma Centers	Specialized hospital facilities which provide diagnostic and therapeutic services for trauma patients.	Trauma Units,Center, Trauma,Centers, Trauma,Trauma Center,Trauma Unit,Unit, Trauma,Units, Trauma
D014947	Wounds and Injuries	Damage inflicted on the body as the direct or indirect result of an external force, with or without disruption of structural continuity.	Injuries,Physical Trauma,Trauma,Injuries and Wounds,Injuries, Wounds,Research-Related Injuries,Wounds,Wounds and Injury,Wounds, Injury,Injury,Injury and Wounds,Injury, Research-Related,Physical Traumas,Research Related Injuries,Research-Related Injury,Trauma, Physical,Traumas,Wound
D015541	Off-Road Motor Vehicles	Motorized, recreational vehicles used on non-public roads. They include all-terrain vehicles, dirt-bikes, minibikes, motorbikes, trailbikes, and snowmobiles. Excludes MOTORCYCLES, which are considered public road vehicles.	All Terrain Vehicle,All-Terrain Vehicles,Dirt Bike,Dirt-Bike,Dirt-Bikes,Minibike,Minibikes,Motor Vehicles, Off-Road,Motorbike,Motorbikes,Off-Road Motor Vehicle,Snowmobile,Snowmobiles,Three-Wheeled Vehicle,Three-Wheeled Vehicles,Three-Wheeler Vehicle,Three-Wheeler Vehicles,All Terrain Vehicles,All-Terrain Vehicle,Bike, Dirt,Bikes, Dirt,Dirt Bikes,Motor Vehicle, Off-Road,Motor Vehicles, Off Road,Off Road Motor Vehicle,Off Road Motor Vehicles,Terrain Vehicle, All,Terrain Vehicles, All,Three Wheeled Vehicle,Three Wheeled Vehicles,Three Wheeler Vehicle,Three Wheeler Vehicles,Vehicle, All Terrain,Vehicle, All-Terrain,Vehicle, Three-Wheeled,Vehicle, Three-Wheeler,Vehicles, All Terrain,Vehicles, All-Terrain,Vehicles, Three-Wheeled,Vehicles, Three-Wheeler
D015601	Injury Severity Score	An anatomic severity scale based on the Abbreviated Injury Scale (AIS) and developed specifically to score multiple traumatic injuries. It has been used as a predictor of mortality.	ISS Score,Injury Severity Scores,Score, Injury Severity,Scores, Injury Severity