PMID- 33978605
OWN - NLM
STAT- MEDLINE
DCOM- 20211110
LR  - 20231020
IS  - 1528-1159 (Electronic)
IS  - 0362-2436 (Linking)
VI  - 46
IP  - 23
DP  - 2021 Dec 1
TI  - Seatbelts Save Lives, and Spines, in Motor Vehicle Accidents: A Review of the 
      National Trauma Data Bank in the Pediatric Population.
PG  - 1637-1644
LID - 10.1097/BRS.0000000000004072 [doi]
AB  - STUDY DESIGN: Database study. OBJECTIVE: The purpose of this study was to use a 
      large, nationwide database to determine prevalence of pediatric spine fractures 
      in the United States, associated injuries, mechanisms of injury (MOI), use of 
      safety devices, and mortality rates. SUMMARY OF BACKGROUND DATA: Spinal fractures 
      account for 1% to 2% of pediatric injuries. However, they are associated with 
      significant comorbidities and complications. Motor vehicle accidents (MVAs) are 
      most responsible for increased incidence observed. METHODS: Retrospective review 
      of National Trauma Data Bank between 2009 and 2014 (analysis in 2019) for all 
      vertebral fractures in patients under 18 years of age. Subanalysis included those 
      in MVAs where protective device use data were available. Patient demographics, 
      MOI, geographical and anatomical region of injury, concomitant 
      musculoskeletal/organ injury, protective device usage, hospital length of stay, 
      surgical procedures, and mortality were all analyzed. RESULTS: A total of 34,563 
      patients with 45,430 fractured vertebrae included. Median age was 15 years. Most 
      fractures (63.1%) occurred in patients aged 15 to 17 years, most frequent MOI was 
      MVA (66.8%), and most common geographic location was the South (38%). Males 
      sustained more spine fractures than females, overall (58.4% vs. 41.6%; P < 0.001) 
      and in MVAs (54.4% vs. 45.6%; P < 0.001). Those in MVAs wearing seatbelts had 
      lower odds of cranial (29.6% vs. 70.4%; odds ratio [OR] = 0.85, 95% confidence 
      interval [CI]: 0.82-0.89; P < 0.001) and thoracic (30.1% vs. 69.9%; OR = 0.88, 
      95% CI: 0.84-0.91; P < 0.001) organ injury, multivertebral (30% vs. 70%; 
      OR = 0.78, 95% CI: 0.73-0.83; P < 0.001) and concomitant nonvertebral fractures 
      (30.9% vs. 69.1%; OR = 0.89, 95% CI:0.73-0.83; P < 0.001), and 21% lower odds of 
      mortality (29.3% vs. 70.7%; OR = 0.79, 95% CI: 0.66-0.94; P = 0.009). Over 70% of 
      drivers were not restrained during MVA, with majority of seatbelt violations 
      incurred by males, ages 15 to 17, in the South. CONCLUSION: Over 60% of pediatric 
      spinal fractures occur in children aged 15 to 17 years, coinciding with the 
      beginning of legal driving. MVA is the most common cause and has significant 
      association with morbidity/mortality. Nearly two- thirds pediatric spinal 
      fractures sustained in MVAs occurred without seatbelts. Absence of seatbelts 
      associated with >20% greater odds of mortality. Ensuring new drivers wear 
      protective devices can greatly reduce morbidity/ mortality associated with 
      MVA.Level of Evidence: 3.
CI  - Copyright (c) 2021 Wolters Kluwer Health, Inc. All rights reserved.
FAU - Sarwahi, Vishal
AU  - Sarwahi V
AD  - Cohen Children's Medical Center, New Hyde Park, NY.
FAU - Atlas, Aaron M
AU  - Atlas AM
AD  - New York Institute of Technology College of Osteopathic Medicine, Old Westbury, 
      NY.
FAU - Galina, Jesse
AU  - Galina J
AD  - Cohen Children's Medical Center, New Hyde Park, NY.
FAU - Satin, Alexander
AU  - Satin A
AD  - Texas Back Institute, Plano, TX.
FAU - Dowling, Thomas J 3rd
AU  - Dowling TJ 3rd
AD  - Plainview Hospital, Northwell Health, Plainview, NY.
FAU - Hasan, Sayyida
AU  - Hasan S
AD  - Cohen Children's Medical Center, New Hyde Park, NY.
FAU - Amaral, Terry D
AU  - Amaral TD
AD  - Cohen Children's Medical Center, New Hyde Park, NY.
FAU - Lo, Yungtai
AU  - Lo Y
AD  - Department of Epidemiology and Population Health, Albert Einstein College of 
      Medicine, Bronx, NY.
FAU - Christopherson, Nathan
AU  - Christopherson N
AD  - Department of Surgery, Hofstra Northwell School of Medicine, Cohen Children's 
      Medical Center, New Hyde Park, NY.
FAU - Prince, Jose
AU  - Prince J
AD  - Department of Surgery, Hofstra Northwell School of Medicine, Cohen Children's 
      Medical Center, New Hyde Park, NY.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Spine (Phila Pa 1976)
JT  - Spine
JID - 7610646
SB  - IM
MH  - *Accidents, Traffic
MH  - Adolescent
MH  - *Automobile Driving
MH  - Child
MH  - Female
MH  - Humans
MH  - Male
MH  - Motor Vehicles
MH  - Retrospective Studies
MH  - Seat Belts
MH  - United States/epidemiology
EDAT- 2021/05/13 06:00
MHDA- 2021/11/11 06:00
CRDT- 2021/05/12 12:21
PHST- 2021/05/13 06:00 [pubmed]
PHST- 2021/11/11 06:00 [medline]
PHST- 2021/05/12 12:21 [entrez]
AID - 00007632-202112010-00009 [pii]
AID - 10.1097/BRS.0000000000004072 [doi]
PST - ppublish
SO  - Spine (Phila Pa 1976). 2021 Dec 1;46(23):1637-1644. doi: 
      10.1097/BRS.0000000000004072.