Sledding while towed behind motorized vehicles associates with more severe and lethal injuries

J Pediatr Surg. 2022 Nov;57(11):644-648. doi: 10.1016/j.jpedsurg.2022.03.011. Epub 2022 Mar 16.

Abstract

Introduction: Our institution has recently experienced an increase in sledding-related injuries, particularly when towed behind motorized vehicles. The purpose of this study was to characterize injury severity and clinical outcomes between pediatric patients who sustain injuries owing to motorized sledding accidents to aid in injury prevention messaging.

Methods: This retrospective study queried all patients who presented with a sledding-related injury to a single ACS-verified Level 1 Pediatric Trauma Center located in the Southeastern United States between 01/2015 and 01/2022. Demographics, injury details, and clinical outcomes were compared between two groups: patients towed behind a motorized vehicle (MOTOR) and those who were not (GRAVITY).

Results: Of the 67 patients included in our analysis, 15 (22%) were in the MOTOR group. Patients in the MOTOR group presented with significantly higher injury severity (ISS) and lower Glasgow coma scale (GCS) scores. Additionally, patients in this MOTOR group more often received a blood transfusion and intubation, had longer intensive care and overall hospital lengths of stay, and incurred higher hospital costs. In a multivariate analysis, the use of a motorized vehicle to sled was independently associated with increased ISS (OR: 9.7, 95% CI 1.9-17.5; p = 0.02). Two deaths occurred after sledding while being towed behind a motorized vehicle.

Conclusion: Children experiencing sledding accidents while being towed by motorized vehicles sustain significantly more severe injuries and require more intensive treatments that together lead to increased hospital costs. These findings provide the framework for community educational initiatives and injury prevention measures to mitigate risk among children engaged in sledding.

Level of evidence: IV retrospective cohort study.

Keywords: ATV; Injury prevention; Pediatric surgery; Sledding; Trauma.

MeSH terms

  • Child
  • Glasgow Coma Scale
  • Humans
  • Injury Severity Score
  • Off-Road Motor Vehicles*
  • Retrospective Studies
  • Snow Sports*
  • Trauma Centers