Rollover injuries in residential driveways: Age-related patterns of injury

Background. The major objective of the present study was to determine the s everity of nonfatal injuries sustained by children (<16 yeats old) when a m otor vehicle rolls over them. We also sought to determine whether younger c hildren (<24 months old) demonstrated different patterns of injury and/or a worse outcome, compared with older children (>24 months old). Methods. We reviewed the medical records of 3971 consecutive admissions to a single trauma service at an urban children's hospital between March 1990 and October 1994. During this time period, 26 (0.7%) children presented wit h rollover injuries incurred by motor vehicles in residential driveways. Ou tcome was measured by length of both intensive care unit admission and hosp italization. Results. Two children died shortly after admission and were excluded from t he remainder of the study. Younger children (<24 months old) had significan tly higher injury severity scores and lower pediatric trauma scale scores. Both the duration in the intensive care unit and the length of hospitalizat ion were significantly longer in younger children, compared with children > 24 months old. One explanation for these observations was that younger chil dren had a significantly higher incidence of both head and neck and extremi ty injury but a similar incidence and severity of chest and abdominal traum a, compared with older children. Injuries requiring operative intervention were rare. Conclusion. Younger patients sustaining rollover injuries in the residentia l driveway have a worse outcome, in part, because of the head and neck or e xtremity injures that they incur. The majority of rollover injuries can be managed conservatively.