Golf cart injuries have similar severity to all-terrain vehicle injuries in children: a multicenter comparison over a 5-year period

Henry L Chang; Brian K Yorkgitis; Lindsey B Armstrong; Keith A Thatch; Donald A Plumley; Robin T Petroze; Shawn D Larson; John W Fitzwater; Oliver B Lao; Michele A Markley; Anne Fischer; Felipe Pedroso; Holly L Neville; Christopher W Snyder

doi:10.1136/tsaco-2023-001286

Golf cart injuries have similar severity to all-terrain vehicle injuries in children: a multicenter comparison over a 5-year period

Trauma Surg Acute Care Open. 2024 May 7;9(1):e001286. doi: 10.1136/tsaco-2023-001286. eCollection 2024.

Authors

Henry L Chang^{1

2}, Brian K Yorkgitis³, Lindsey B Armstrong¹, Keith A Thatch^{1

2}, Donald A Plumley⁴, Robin T Petroze⁵, Shawn D Larson⁵, John W Fitzwater^{6

7}, Oliver B Lao⁸, Michele A Markley⁹, Anne Fischer¹⁰, Felipe Pedroso¹¹, Holly L Neville⁸, Christopher W Snyder¹

Affiliations

¹ Pediatric Surgery, Johns Hopkins All Children's Hospital, St Petersburg, Florida, USA.
² Tampa General Hospital, Tampa, Florida, USA.
³ Surgery, University of Florida College of Medicine - Jacksonville, Jacksonville, Florida, USA.
⁴ Orlando Health Arnold Palmer Hospital for Children, Orlando, Florida, USA.
⁵ University of Florida, Gainesville, Florida, USA.
⁶ St Joseph's Hospitals Foundation, Tampa, Florida, USA.
⁷ Baylor Scott & White Medical Center Temple, Temple, Texas, USA.
⁸ Joe DiMaggio Children's Hospital, Hollywood, Florida, USA.
⁹ Broward Health, Fort Lauderdale, Florida, USA.
¹⁰ Tenet Florida Healthcare Systems, Coral Springs, Florida, USA.
¹¹ Nicklaus Children's Hospital, Miami, Florida, USA.

Abstract

Background: Golf carts (GCs) and all-terrain vehicles (ATVs) are popular forms of personal transport. Although ATVs are considered adventurous and dangerous, GCs are perceived to be safer. Anecdotal experience suggests increasing numbers of both GC and ATV injuries, as well as high severity of GC injuries in children. This multicenter study examined GC and ATV injuries and compared their injury patterns, resource utilization, and outcomes.

Methods: Pediatric trauma centers in Florida submitted trauma registry patients age <16 years from January 2016 to June 2021. Patients with GC or ATV mechanisms were identified. Temporal trends were evaluated. Injury patterns, resource utilization, and outcomes for GCs and ATVs were compared. Intensive care unit admission and immediate surgery needs were compared using multivariable logistic regression.

Results: We identified 179 GC and 496 ATV injuries from 10 trauma centers. GC and ATV injuries both increased during the study period (R² 0.4286, 0.5946, respectively). GC patients were younger (median 11 vs 12 years, p=0.003) and had more intracranial injuries (34% vs 19%, p<0.0001). Overall Injury Severity Score (5 vs 5, p=0.27), intensive care unit (ICU) admission (20% vs 16%, p=0.24), immediate surgery (11% vs 11%, p=0.96), and mortality (1.7% vs 1.4%, p=0.72) were similar for GCs and ATVs, respectively. The risk of ICU admission (OR 1.19, 95% CI 0.74 to 1.93, p=0.47) and immediate surgery (OR 1.04, 95% CI 0.58 to 1.84, p=0.90) remained similar on multivariable logistic regression.

Conclusions: During the study period, GC and ATV injuries increased. Despite their innocuous perception, GCs had a similar injury burden to ATVs. Heightened safety measures for GCs should be considered.

Level of evidence: III, prognostic/epidemiological.

Keywords: Accidents, Traffic; Brain Injuries, Traumatic; COVID-19; pediatric.