Patterns of injury to restrained children in side impact motor vehicle crashes:​ the side impact syndrome

Orzechowski, Kelly M.; Edgerton, Elizabeth A.; Bulas, Dorothy I.; McLaughlin, Patrick M.; Eichelberger, Martin R.

Affiliations

¹Department of Emergency Trauma Services, Children's National Medical Center, Washington, D.C.

²Division of Emergency Medicine, Children's National Medical Center, Washington, D.C.

³Department of Radiology, Children's National Medical Center, Washington, D.C.

⁴Department of Emergency Trauma Services, Children's National Medical Center, Washington, D.C.

⁵Department of General Surgery, Trauma and Burn ServicesC, hildren's National Medical Center, Washington, D.C.

Abstract and keywords

Background: Injury patterns among children in frontal collisions have been well documented, but little information exists regarding injuries to children in side impact collisions.

Methods: Restrained children 14 years old or younger admitted to the hospital for crash injuries were analyzed. Data concerning injuries, medical treatment, and outcome were correlated with crash data. Case reviews achieved consensus regarding injury contact points. Side impacts were compared with frontal impacts. These results were then compared with data from the National Automotive Sampling System.

Results: There were no differences between the groups with respect to age, sex, restraint type, or seat position. Compared with frontal crashes, children in side impacts were more likely to have an Injury Severity Score > 15 (odds ratio [OR], 3.1; 95% confidence interval [CI], 1.7-5.8) and were more likely to have Abbreviated Injury Scale score 2+ injuries to the head (OR, 2.5; 95% CI, 1.4-4.4), chest (OR, 4.0; 95% CI, 2.0-8.0), and cervical spine (OR, 3.7; 95% CI, 1.2-11.3). When compared with National Automotive Sampling System data, similar trends were seen regarding Abbreviated Injury Scale score 2+ injuries to the head, chest, and extremities.

Conclusion: In this study population, side impacts resulted in more injuries to the head, cervical spine, and chest. Knowledge of this pattern—the side impact syndrome —can help guide diagnosis, treatment, and prevention strategy.

Keywords: Motor vehicle crash, Children, Trauma, Injury, Frontal impacts, Side impacts

Links

DOI: 10.1097/01.TA.0000067288.11456.98

PubMed: 12813328

WoS: 000183727400012

Ovid: 00005373-200306000-00008

History

Received: 2002-10-07

Accepted: 2003-02-24

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