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J Pediatr Surg. 2018 May 5. pii: S0022-3468(18)30316-6. doi: 10.1016/j.jpedsurg.2018.04.042. [Epub ahead of print]

Pediatric golf cart trauma: Not par for the course.

Author information

1
Department of Surgery, Memorial University Medical Center, Savannah, Georgia. Electronic address: bmtracy06@gmail.com.
2
Department of Surgery, Memorial University Medical Center, Savannah, Georgia. Electronic address: millekr2@memorialhealth.com.
3
Department of Surgery, Memorial University Medical Center, Savannah, Georgia. Electronic address: thompas3@memorialhealth.com.
4
Department of Surgery, Memorial University Medical Center, Savannah, Georgia. Electronic address: jocooke-barber@memorialhealth.com.
5
The Mercer University School of Medicine-Savannah, Savannah, Georgia. Electronic address: bloodworth_jp@med.mercer.edu.
6
Department of Research, Memorial University Medical Center, Savannah, Georgia. Electronic address: Clayter1@memorialhealth.com.
7
Department of Surgery, Memorial University Medical Center, Savannah, Georgia. Electronic address: boswewi1@memorialhealth.com.

Abstract

INTRODUCTION:

Golf cart trauma in southeast Georgia represents a significant source of morbidity in the pediatric population. We believe these events are related to the introduction of new state legislation that allows local authorities to govern golf cart operation.

METHODS:

We performed a retrospective review from 2010 to 2016 of children involved in golf cart traumas (n = 46). We recorded age, gender, Glasgow Coma Scale score (GCS), Injury Severity Score (ISS), location of event, and patient position during event. Outcomes included injury type and length of stay (LOS).

RESULTS:

The most common position in a golf cart was a passenger (52.2%). Events varied regionally and correlated with stringency of local legislation. Skull fractures afflicted 48% (n = 22) of children and traumatic brain injuries (TBIs) were noted in 35% (n = 17) of patients. TBIs (LOS = 4.6 days, p = 0.006) and abdominal injuries (LOS = 8.5 days, p = 0.017) lengthened mean hospital stay. Increasing ISS was associated with an increased probability of sustaining a TBI (OR 1.295, p = 0.004). Younger children were more likely to sustain a skull fracture (OR 1.170, p = 0.034) while older children incurred more orthopedic injuries (OR 1.217, p = 0.045).

CONCLUSION:

Skull fractures and TBIs are common following pediatric golf cart trauma. Georgia's varying municipality legislation likely contributes to the growing frequency of this trend.

LEVEL OF EVIDENCE:

Retrospective study, IV.

KEYWORDS:

Golf cart; Legislation; Pediatric trauma; Skull fracture; Traumatic brain injury

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