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Safety/booster seats in pediatric motor vehicle crashes: Public health concern - 19/01/24

Doi : 10.1016/j.ajem.2023.11.053 
Jeffrey Santos, MD a, Areg Grigorian, MD a, , Morgan Schellenberg, MD MPH b, Kazuhide Matsushima, MD b, Jeffry Nahmias, MD MHPE a, Rebecca Barros, MD c, Kenji Inaba, MD b
a University of California, Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, Orange, CA, USA 
b Division of Acute Care Surgery, LAC+USC Medical Center, University of Southern California, Los Angeles, CA, USA 
c Children's Hospital of Orange County, CHOC Medical Group, Orange, CA, USA 

Corresponding author at: Assistant Clinical Professor of Surgery, Division of Trauma, Burns and Surgical Critical Care, Department of Surgery, University of California, Irvine Medical Center, 3800 Chapman Ave, Suite 6200, Orange, CA 92868-3298, USA.Assistant Clinical Professor of SurgeryDivision of Trauma, Burns and Surgical Critical CareDepartment of SurgeryUniversity of CaliforniaIrvine Medical Center3800 Chapman Ave, Suite 6200OrangeCA92868-3298USA

Abstract

Introduction

The American Academy of Pediatrics (AAP) guidelines recommend that children ≤12-years-old with height < 145 cm should use safety/booster seats. However, national adherence and clinical outcomes for eligible children involved in motor vehicle collisions (MVCs) are unknown. We hypothesized that children recommended to use safety/booster seats involved in MVCs have a lower rate of serious injuries if a safety/booster seat is used, compared to children without safety/booster seat.

Methods

This retrospective cohort study queried the 2017–2019 Trauma Quality Improvement Program database for patients ≤12-years-old and <145 cm (recommendation for use of safety/booster seat per American Academy of Pediatrics) presenting after MVC. Serious injury was defined by abbreviated injury scale grade ≥3 for any body-region. High-risk MVC was defined by authors in conjunction with definitions provided by the Centers for Disease Control and Prevention and the American College of Surgeons Committee on Trauma.

Results

From 8259 cases, 41% used a safety/booster seat. There was no difference in overall rate of serious traumatic injuries or mortality (both p > 0.05) between the safety/booster seat and no safety/booster seat groups. In a subset analysis of high-risk MVCs, the overall use of safety/booster seats was 56%. The rate of serious traumatic injury (53.6% vs. 62.1%, p = 0.017) and operative intervention (15.8% vs. 21.6%, p = 0.039) was lower in the safety/booster seat group compared to the no safety/booster seat group.

Conclusions

Despite AAP guidelines, less than half of recommended children in our study population presenting to a trauma center after MVC used safety/booster seats. Pediatric patients involved in a high-risk MVC suffered more serious injuries and were more likely to require surgical intervention without a safety/booster seat. A public health program to increase adherence to safety/booster seat use within this population appears warranted.

Le texte complet de cet article est disponible en PDF.

Highlights

Pediatric safety seats decrease rates of injury and mortality.
Variability in recommendations for use of safety/booster seats.
41% adherence rate to American Academy of Pediatrics guidelines for safety seat use.
Safety seat use had lower rates of severe injury and need for surgery.

Le texte complet de cet article est disponible en PDF.

Keywords : Pediatric trauma, Safety seat, Pediatric car seat, Booster seat, Motor vehicle collision

Abbreviations : AAP, ACS-COT, AIS, CDC, ED, ISS, LOS, MVC, NHTSA, STROBE, TQIP


Plan


 This manuscript was presented at the Academic Surgical Congress in Houston, TX on February 9, 2023.


© 2023  The Authors. Publié par Elsevier Masson SAS. Tous droits réservés.
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Vol 76

P. 180-184 - février 2024 Retour au numéro
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