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New research shows golf carts causing serious injuries to children

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CHICAGO – As golf carts become increasingly popular in communities beyond the fairway, new research shows, a significant number of children are being seriously injured while using them. The study abstract, "Golf Carts and Children: An 11-year Single State Experience," will be presented on Monday, Sept. 18, at the American Academy of Pediatrics 2017 National Conference & Exhibition in Chicago.

Researchers looked at Pennsylvania's state trauma center database and identified 108 patients under age 18 who were treated between January 2004 and December 2014 for injuries they sustained while using a golf cart. These children averaged 11 years of age and spent anywhere from one to 26 days in the hospital for their injuries. Among other findings:

  • There was one fatality, and intensive care unit (ICU) admission was required in 36 percent of the patients.
  • More than three-quarters of the children (76 percent) broke at least one bone. Skull fractures were more prevalent than extremity fractures.
  • More than a quarter of the children (27 percent) sustained a concussion, while between 25 percent and 30 percent of children had intracranial injury and bleeding within the skull.

"Just because golf carts don't usually reach speeds other recreational vehicles can, this doesn't mean they are harmless," said Mariano Garay, MD, a Penn State College of Medicine researcher who is one of the abstract's authors.

While injuries to children using all-terrain vehicles (ATVs) are getting increased attention, he said, parents still may not realize how dangerous golf carts can be for children because research has been more limited.

This lack of awareness about the hazard golf carts pose to children contributes to the high rate of head injuries, said William Hennrikus, MD, FAAP, a senior author of the abstract and pediatric orthopedic surgeon in Hershey, Penn, especially since helmets usually aren't worn while using the carts. Skull fractures accounted for nearly half (44 percent) of all fractures children in the study sustained.

"We recommend that children under 16 years old not drive the golf cart at all," he said, "and when golf carts are used, they should be driven at cautious speeds, under 10 miles per hour."

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Dr. Garay will present the abstract, available below, from 3:18 p.m. to 3:26 p.m. in room S106 at McCormick Place West.

Note: Another abstract describing research into golf cart injuries in children, "Characterization of Pediatric Golf Cart Injuries to Guide Injury Prevention Efforts," will be presented on Monday, Sept. 18 between 4:20 and 4:25 p.m. during the conference.

Only the abstract of studies are being presented at the meeting. In some cases, the researcher may have more data available to share with media, or may be preparing a longer article for submission to a journal.

The American Academy of Pediatrics is an organization of 66,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit http://www.aap.org.

Abstract Title: Golf Carts and Children: An 11-year Single State Experience

Objective: Golf cart injuries in children have not received as much attention as other recreational vehicles such as ATVs. The knowledge gap regarding these injuries needs evaluation since studies have shown they can have devastating consequences in children (1-4). We aimed to establish the incidence and injury characteristics of pediatric patients injured while using golf carts over an 11-year period. We present a multicenter, single-state cohort of children and adolescents admitted to trauma centers due to golf cart injuries. Methods: Retrospective study using our state trauma database for patients ages 0-17 years, who sustained injuries while using a golf cart. Thirteen Pediatric and Adult Trauma Centers within the state were evaluated from January 1, 2004 to December 31, 2014. Results: There were 108 patients who met the inclusion criteria. The estimated mean annual incidence during the study was 0.36 cases per 100,000 patients (range 0.18-0.47/100,000). The median age of patients was 11 years (range 0-17 years). The median hospital length of stay (LOS) was 2 days (range 1-26 days). The median injury severity (ISS) score was 9.5 (range 1-30). Children aged 0-5 and 6-11 had a median LOS of 1 day, which was lower than those aged 12-15 years (3 days), p-value of 0.01 and 0.009, respectively. There was no significant difference in the ISS due to age. Intensive care unit (ICU) admission was required in 36% of the patients. Although not statistically significant, patients in age groups 6-11 years, 12-15 year, & 16-17 years had higher odds to be admitted to the ICU than those aged 0-5 years [OR 3.3, 3.1, & 2, p-value =0.29, respectively]. The majority of the patients (76%) sustained at least one bone fracture. Skull fractures were more prevalent than extremity fractures (44% vs. 27%, respectively). Older children (6-11 years, 12-15 years, & 16-17 years) had lower odds of sustaining a fracture than younger children [OR 0.29, 0.46, & 0.53, p-value =0.39, respectively]. The concussion rate within the study was 27%. Intracranial injury and intracranial hemorrhage were sustained by 25% and 30% of patients, respectively. Neither age group nor sex was associated with a difference in fractures, intracranial injuries, intracranial hemorrhage, or concussions. Children 6-11 years had higher odds of sustaining a concussion than those 0-5 years [OR 1.7, 95% CI (0.46-6.1)]. There was one fatality (0.9%) within the cohort. Conclusions: Golf cart accidents in children are associated with significant injuries (1-4). Despite the risk of injury, we are unaware of any guidelines for parents or physicians regarding their use among children. The high incidence of head trauma and fractures within this cohort warrants evaluation by professional medical organizations with aims to establish parental guidance regarding the use of golf carts.

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Laura Milani Alessio
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847-434-4276
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