ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2022
Prevention of severe injuries of child passengers in motor vehicle accidents: is re-boarding sufficient?
Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.
- Pediatric motor vehicle crashes injuries: A systematic review for forensic evaluation.International journal of legal medicine · 2024Pooled it
- Clinical characteristics, management, and outcomes of polytraumatized children: a retrospective cohort study.International journal of emergency medicine · 2026Article
- Preventing the disaster: severe abdominal injury in child passengers of motor vehicle accidents often indicate even more serious trauma.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Article
- Trends and characteristics of severe road traffic injuries in children: a nationwide cohort study in Japan.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024Article
- Increased CT Use and No Change in Injury Severity among Child Motor Vehicle Victims: A National Trauma Database Study in Japan.Healthcare (Basel, Switzerland) · 2023Article
- Pediatric intensive care unit admissions network-rationale, framework and method of operation of a nationwide collaborative pediatric intensive care research network in Germany.Frontiers in pediatrics · 2023Article
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Authors and funding
9 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe purpose of this study was to evaluate whether prolonged re-boarding of restraint children in motor vehicle accidents is sufficient to prevent severe injury.
methodsData acquisition was performed using the Trauma Register DGU® (TR-DGU) in the time period from 2010 to 2019 of seriously injured children (AIS 2 +) aged 0-5 years as motor vehicle passengers (MVP). Primarily treated and transferred patients where included.
resultsThe study group included 727 of 2030 (35.8%) children, who were severely injured (AIS 2 +) in road traffic accidents, among them 268 (13.2%) as MVPs in the age groups: 0-1 years (42.5%), 2-3 years (26.1%) and 4-5 years (31.3%). The pattern of severe injury was head/brain (56.0%), thoracic (42.2%), abdominal (13.1%), fractures (extremities and pelvis, 52.6%) and spine/severe whiplash (19.8%). The 0-1-year-old MVPs showed the significantly highest proportion of brain injuries with Glasgow Coma Score (GCS) < 8 and severe injury to the spine. The 2-3-year-olds showed the significantly highest proportion of fractures especially the lower extremity and highest proportion of cervical spine injuries of all spine injuries, while the 4-5-year-olds, the significantly highest proportion of abdominal injury and second highest proportion of cervical spine injury of all spine injuries. MVPs of the 0-1-year-old and 2-3-year-old groups showed a higher median Injury Severity Score (ISS) of 21.5 and 22.1 points than the older children (17.0 points). They also suffered an AIS-6-injury significantly more often (9 of 21) of spine (p = 0.001). Especially the cervical spine was significantly more often involved. Passengers at the age of 0-1 years were treated with cardiopulmonary resuscitation (CPR) three times as often as older children in the prehospital setting and twice as often at admission in the Trauma Resuscitation Unit (TRU). Their survival rate was 7 out of 8 (0-1 years), 1 out of 6 (2-3 years) and 1 out of 4 (4-5 years).
conclusionAlthough the younger MVPs are restraint in a re-boarding position, severe injury to the spine and head occurred more often, while older children as front-faced positioned MVPs suffered from significantly higher rates of abdominal and more often severe facial injury. Our data show, that it is more important to properly restrain children in their adequate car seats (i-size-Norm) and additionally consider the age-related physiological and anatomical specific risks of injury as well as co-factors in road traffic accidents, than only prolonging the re-boarding position over the age of 15 months as a single method.
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