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Errington C. Thompson, MD; Paul Perkowski, MD; David Villarreal, MD; Ernest F. J. Block, MD; Mark F. Brown, MD; Lana Wright, RN, CRNFA; Shelley Akin, RN, MSN, CS

Arch Surg. 2003;138:142-145.

Hypothesis  The use of passenger compartment safety measures has not led to decreases in pediatric morbidity or mortality in our population of patients.

Design  Retrospective review.

Setting  University, tertiary care, level I trauma center.

Patients  All patients admitted to the Trauma Center at Louisiana State University Health Science Center School of Medicine in Shreveport between July 1, 1991, and December 31, 2000, who were younger than 16 years and involved in a motor vehicle crash.

Main Outcome Measures  Intensive care complications, postoperative complications, and mortality.

Results  We reviewed the experience of all pediatric patients involved in motor vehicle crashes and transported to the Trauma Center at Louisiana State University Health Science Center School of Medicine in Shreveport from July 1, 1991, through December 31, 2000. A total of 191 patients met these criteria. There were 8 deaths, and only 1 of these patients was restrained. There were significantly more injuries in those patients who died compared with those who survived (Modified Injury Severity Score, 29 vs 9; P<.001). We compared the use of restraints in our cohort with the use of restraints in the US pediatric population. Only 20% of our patients were restrained vs 68% of the general pediatric population. This difference was significant (P<.001, ² test).

Conclusions  In our population of patients, death was a relatively infrequent occurrence. All patients who died presented in extremis. No patient died as the result of a complication. The rate of seat belt use in our population of patients was low. The exact reason for why we were unable to detect any survival benefit with seat belt use is unclear and demands further investigation.

From the Division of Trauma, the Department of Surgery, Louisiana State University Health Science Center School of Medicine in Shreveport (Drs Thompson, Perkowski, Villarreal, and Brown and Mss Wright and Akin); Trauma Services, Trinity Mother Frances Hospital, Tyler, Tex (Dr Thompson); and Orlando Regional Medical Center, Orlando, Fla (Dr Block).