255. Children Struck By Motor Vehicles: Factors Associated With Subsequent Head Injury

Authors: Karlisha Person-Jones; Katherine Harmon, PhD; Carolyn Quinsey, MD; Weston Northam, MD (Chapel Hill, NC)

Introduction:

Little is known about patient and vehicle characteristics that are associated with head injury.  This study merges crash report data with clinical information to identify factors associating children struck by a motor vehicle and subsequent head injury.

Methods:

After IRB approval, 2,057 children <18 struck by a motor vehicle were identified by NCDOT with detailed crash information from 2014 to 2017. Of the 298 patients identified, 50 received care at our academic medical center. A retrospective review was conducted in the electronic medical record to describe patient demographics and injuries. Pairwise comparisons were performed for patients with head injuries to patients without head injuries utilizing Pearson’s χ2 test and Fisher’s Exact test for categorical variables and Wilcoxon rank sum test for continuous variables.

Results:

Of the 50 patients with both crash report and clinical data, 76% (n=38) were pedestrians and 24% (n=12) were bicyclists. Males constituted 66% (n=33) of the patient population. The median age of struck patients was 11 (IQR 6-15). Traumatic brain injuries and/or other head injuries were diagnosed in 42% (n=21) of patients upon admission. Patient body height (p = 0.04), striking vehicle type (p = 0.02), and police-estimated impact speed (p = 0.002) were significantly associated with pediatric head injury. Children 1.5 M and shorter were statistically less likely to sustain head injury, and more likely to go under the car and sustain burns and orthopedic injuries.

Conclusion:

In the population of pediatric patients struck by motor vehicles, factors associated with head injury included the patient’s body height, the impact speed, and the type of striking vehicle. Vehicle crash report data has not been previously leveraged against clinical outcomes of traumatic brain injury, and may be useful to identify children at an elevated risk of injury.