Injury Patterns, Imaging Usage, and Disparities Associated With Car Restraint Use in Children.

Autor:	McCauley CJ; Department of Surgery, University of North Carolina, Chapel Hill, NC, USA., Purcell LN; Department of Surgery, University of North Carolina, Chapel Hill, NC, USA., Schiro SE; Department of Surgery, University of North Carolina, Chapel Hill, NC, USA., Nakayama DK; Division of Pediatric Surgery, University of North Carolina, Chapel Hill, NC, USA., McLean SE; Division of Pediatric Surgery, University of North Carolina, Chapel Hill, NC, USA.
Jazyk:	angličtina
Zdroj:	The American surgeon [Am Surg] 2023 Dec; Vol. 89 (12), pp. 5858-5864. Date of Electronic Publication: 2023 May 23.
DOI:	10.1177/00031348231175455
Abstrakt:	Background: Motor vehicle collision (MVC) is a leading cause of accidental death in children. Despite effective forms of child safety restraint (eg, car seat and booster seat), studies demonstrate poor compliance with guidelines. The goal of this study was to delineate injury patterns, imaging usage, and potential demographic disparities associated with child restraint use following MVC. Methods: A retrospective review of the North Carolina Trauma Registry was performed to determine demographic factors and outcomes associated with improper restraint of children (0-8 years) involved in MVC from 2013 to 2018. Bivariate analysis was performed by the appropriateness of restraint. Multivariable Poisson regression identified demographic factors for the relative risk of inappropriate restraint. Results: Inappropriately restrained patients were older (5.1 years v. 3.6 yrs, P < .001) and weighed more (44.1 lbs v. 35.3 lbs, P < .001). A higher proportion of African American (56.9% v. 39.3%, P < .001) and Medicaid (52.2% v. 39.0%, P < .001) patients were inappropriately restrained. Multivariable Poisson regression showed that African American patients (RR 1.43), Asian patients (RR 1.51), and Medicaid payor status (RR 1.25) were associated with a higher risk of inappropriate restraint. Inappropriately restrained patients had a longer length of stay, but injury severity score and mortality were no different. Discussion: African American children, Asian children, and Medicaid insurance payor status patients had an increased risk of inappropriate restraint use in MVC. This study describes unequal restraint patterns in children, which suggests opportunity for targeted patient education and necessitates research to further delineate the underlying etiology of these differences. Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
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