Pediatric ATV injuries: Incidence and cost in the state of Pennsylvania

Background: ATV (All-Terrain Vehicle) injuries are a source of significant morbidity in mortality across all age groups. Pennsylvania is second in ATV related injury and deaths with children < 16 accounting for 28% of these injuries in 2007. Despite recommendations from the American Academy of Pediatrics that children under 16 not drive ATV's, children < 12 accounted for 51% of ATV related hospital admissions. We hypothesized that these injuries carry a substantial cost. Methods: Population-based retrospective cohort design. We reviewed the costs of care of children injured during a four-wheeled ATV accident from January 1, 2007, to December 31, 2009 admitted to a level 1 trauma center in the state of Pennsylvania. Results: In this cohort of 78 patients (age 2-16) involved in ATV accidents, the cost of care varied greatly, from a few hundred dollars to over $300,000. Older patients had higher costs on average. Patients wearing helmets were drivers, or had a rollover or ejection had lower costs on average; however, none of these trends were statistically significant in this sample. The statistically significant finding was related to hospital LOS: patients involved in rollover accidents were much more likely to require a hospital stay of one day or longer (Odds Ratio 3.45, p=0.02). Additionally, patients wearing helmets were marginally less likely to require an overnight hospital admission (Odds Ratio 0.34, p=0.07). Conclusion: Interventions to increase helmet use among ATV riders and measures to improve ATV stability seem warranted.