A retrospective study by two UNM surgeons of patients admitted to UNM Hospital after all terrain vehicle (ATV) accidents shows ATV crashes result in serious injuries with people often requiring surgery and long ICU and hospital stays. The study shows children are over represented in these types of accidents and 40 percent of kids suffer some type of head injury when involved in such accidents.
All-Terrain Vehicle (ATV) Related Injuries: A New Mexico Public Menace" is the title of a retrospective four-year chart review performed by D.S. Heffernan, M.D., and Gerald Demarest, III, M.D., of all patients admitted with ATV-related injuries to UNM Hospital the only Level One Trauma Center in the state. The surgeons looked at a variety of factors including demographics, types of injuries sustained, whether helmets were used, operative treatment required and length of stay in the hospital and ICU.
Nationally, statistics have rarely been collected showing ATV-related accidents as a separate category from other motor vehicle accidents although the American College of Surgeons is beginning to capture such data. In the UNM study, data was supplemented by the New Mexico Office of the Medical Investigator and the National Trauma Data Bank.
Particularly alarming was data collected on children. Out of 170 patients, 133 were male with the average age being 23. However, 35 percent of the injuries were in children 15 years old and younger. That figure represents triple the number of children injured than in other types of accidents minors account for only 10.6 percent of all blunt trauma victims and only 7.5 percent of motor vehicles victims. The data shows only 24 percent of those 15 and under were wearing headgear at the time of their accident, and some 40 percent of the children received some sort of head injury.
"Normally you don't see kids breaking bones or sustaining head injuries in rates comparable to adults," said Heffernan. "We've actually had the injury rates of children decline in auto accidents due to more involvement with seat restraints. But with ATVs, minors are experiencing the same types of serious injuries as adults."
Alcohol was a factor in 14 percent of the injuries.
Head injuries were present in 63 (almost 37 percent) of the patients seen, while 54 (31.7 percent) had some sort of bone fracture. Chest wounds were also present in 28 percent of the cases. Spinal, pelvic and cervical spine injuries were shown in much more significant numbers than commonly seen in other types of motor vehicle accidents.
That the injuries were more severe than other types of blunt trauma injury could be seen by the length of ICU stays and surgery rates.
"Increasingly, trauma is being managed in a nonsurgical manner, but ATV-injured patients were more likely to need surgery," said Heffernan. The study shows almost 40 percent of the ATV-injured patient needed to undergo some surgery with nine percent needing more than one operation. And while most trauma bone fractures today can be set in the ER or a doctor's office, 60 percent of the fractures from ATV accidents were complicated enough to require surgery.
Some 29 percent of the men and 28 percent of women required an ICU stay after their accident; and 63 percent of patients with head injuries required an average of a week's stay in the ICU (some were there for up to 32 days). The average total hospital stay was 10.5 days.
Wearing head gear reduced both head injuries and their seriousness. Of those patients who had been wearing a helmet, only 23 percent compared to close to the 40 percent of all patients not wearing a helmet received a head injury. And only half of those with head injuries required an ICU stay.
There were two deaths both in patients who were older than 60 in the UNM population. OMI reported there have been 68 deaths in the past 20 years in New Mexico from ATV accidents; 58 of those deaths were drivers of a vehicle. The banning of three-wheel ATVs in 1988 has not decreased the death rate.
"These are not just fancy toys," said Heffernan. "We need to be looking at ways to make them safer."
"We should be requiring helmets and other safety devices," said Demarest.
Contact: Cindy Foster, 272-3322