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Pediatric Surgery International

, Volume 34, Issue 11, pp 1189–1193 | Cite as

Analysis of water sports injuries admitted to a pediatric trauma center: a 13 year experience

  • Thomas A. Boyle
  • Kittu A. Rao
  • Davis B. Horkan
  • Marguerite L. Bandeian
  • Juan E. Sola
  • Charles A. Karcutskie
  • Casey Allen
  • Eduardo A. Perez
  • Edward B. Lineen
  • Anthony R. Hogan
  • Holly L. Neville
Original Article

Abstract

Background

Unintentional injury is the leading cause of death in children and adolescents. Injuries occurring during boating and recreational water sports are poorly described in the literature. Herein, we compare injuries from water sports to those resulting from motor vehicle collisions, which are better described in existing literature.

Methods

A retrospective review of 1935 consecutive pediatric trauma patients, as defined by age < 18 years, admitted to a single level-1 pediatric trauma center between January 2000 and August 2013 was performed. Patients were divided into two cohorts based on the mechanism of injury: water sports injury (WSI) or motor vehicle collision (MVC). Demographics, injury descriptors, and outcomes were reviewed for each patient. Categorical variables were compared by Chi square or Fisher’s exact test, and continuous by t test or Mann–Whitney U test. Parametric data are reported as mean ± standard deviation and nonparametric as median (interquartile range). Significance was set at alpha level 0.05.

Results

A total of 18 pediatric patients were admitted for WSI and 615 for MVC during the study period. Among those with WSI, mean age was 12 ± 4 years, mean Injury Severity Score (ISS) was 11 ± 10, and mean Revised Trauma Score (RTS) was 7.841(IQR 6.055–7.841). 44% of WSI occurred by personal watercraft (Jet Ski, WaveRunner), 39% by boat, and 17% by other means (e.g., diving, tubing, kite surfing). Overall, the most common WSI included skin/soft-tissue lacerations (59%), head injury/concussion (33%), tendon/ligament lacerations (28%), and extremity fractures (28%). Compared to 615 patients admitted for MVC, age, sex, race, Glasgow Coma Scale, ISS, RTS, spleen and liver laceration rates, neurosurgical consultation, ICU admission, ICU and total length of stay, and mortality were similar. Patients with WSI were more likely to be tourists (44% vs. 5%, p < 0.001). Those with WSI showed a significantly higher requirement for any surgical intervention (61% vs. 15%, p = 0.001). The rate of open fracture (28% vs. 6%, p = 0.006) and, subsequently, orthopedic procedures (39% vs. 17%, p = 0.027) were also higher in the WSI group.

Conclusion

Overall, water sports injuries are similar in in-hospital mortality to motor vehicle collisions. They are more likely to result in penetrating trauma and more likely to require surgical intervention. Primary and secondary prevention strategies should specifically target personal watercraft usage and tourist populations.

Keywords

Pediatrics Trauma Water sports Boat Personal watercraft Motor vehicle 

Abbreviations

AIS

Abbreviated injury severity scale

GCS

Glasgow coma scale

ISS

Injury severity score

MVC

Motor vehicle collision

RTS

Revised trauma score

WSI

Water sports injury

Notes

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Compliance with ethical standards

Conflict of interest

Thomas A. Boyles declares that he has no conflict of interest. Kittu (A) Rao declares that he has no conflict of interest. Davis (B) Horkan declares that he has no conflict of interest. Marguerite L. Bandeian declares that she has no conflict of interest. Juan E. Sola declares that he has no conflict of interest. Charles A. Karcutskie declares that he has no conflict of interest. Casey Allen declares that he has no conflict of interest. Eduardo (A) Perez declares that he has no conflict of interest. Edward (B) Lineen declares that he has no conflict of interest. Anthony R. Hogan declares that he has no conflict of interest. Holly L. Neville declares that she has no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

References

  1. 1.
    Theurer WM, Bhavsar AK (2013) Prevention of unintentional childhood injury. Am Fam Physician 87(7):502–509PubMedGoogle Scholar
  2. 2.
    CDC (2016) Road Traffic Safety. https://www.cdc.gov/safechild/road_traffic_injuries/. Accessed April 28, 2016
  3. 3.
    USCG (2016) Recreational boating statisticsGoogle Scholar
  4. 4.
    Day C et al (2008) Diving-related injuries in children < 20 years old treated in emergency departments in the United States: 1990–2006. Pediatrics 122(2):e388–e394CrossRefGoogle Scholar
  5. 5.
    Keijzer R et al (2013) Watercraft and watersport injuries in children: trauma mechanisms and proposed prevention strategies. J Pediatr Surg 48(8):1757–1761CrossRefGoogle Scholar
  6. 6.
    Petronis KA, Welch JC, Pruitt CW (2009) Independent risk factors for beach-related injuries in children. Clin Pediatr (Phila) 48(5):534–538CrossRefGoogle Scholar
  7. 7.
    Purvis JM, Burke RG (2001) Recreational injuries in children: incidence and prevention. J Am Acad Orthop Surg 9(6):365–374CrossRefGoogle Scholar
  8. 8.
    Wadlow K (2016) South Florida is the deadliest place in the state for boaters. In: Miami HeraldGoogle Scholar
  9. 9.
    Herrera C (2017) Miami-Dade tourism got ‘knocked down’ in 2017. But things are looking up for next year. In: Miami HeraldGoogle Scholar
  10. 10.
    Stevenson M et al (2001) An overview of the injury severity score and the new injury severity score. Injury Prev 7(1):10–13CrossRefGoogle Scholar
  11. 11.
    Kondo Y et al (2011) Revised trauma scoring system to predict in-hospital mortality in the emergency department: Glasgow Coma Scale, age, and systolic blood pressure score. Crit Care 15(4):R191CrossRefGoogle Scholar
  12. 12.
    Johnston BD, Ebel BE (2013) Child injury control: trends, themes, and controversies. Acad Pediatr 13(6):499–507CrossRefGoogle Scholar
  13. 13.
    Sorenson SB (2011) Gender disparities in injury mortality: consistent, persistent, and larger than you’d think. Am J Public Health 101(Suppl 1):S353–S358CrossRefGoogle Scholar
  14. 14.
    Leonard J et al (2016) A multi-institutional study of hemostatic gauze and tourniquets in rural civilian trauma. J Trauma Acute Care Surg 81(3):441–444CrossRefGoogle Scholar
  15. 15.
    Kue RC et al (2015) Tourniquet use in a civilian emergency medical services setting: a descriptive analysis of the Boston EMS experience. Prehosp Emerg Care 19(3):399–404CrossRefGoogle Scholar
  16. 16.
    Baddour LM (2018) Soft tissue infections following water exposure. https://www.uptodate.com/contents/soft-tissue-infections-following-water-exposure. Retrieved July 14
  17. 17.
    Di Flumeri G et al (2009) Anorectal and perineal injury due to a personal watercraft accident: case report and review of the literature. Chir Ital 61(1):131–134PubMedGoogle Scholar
  18. 18.
    Descottees B et al (2003) Rectal injury caused by personal watercraft accident: report of a case. Dis Colon Rectum 46(7):971–973CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Thomas A. Boyle
    • 1
  • Kittu A. Rao
    • 1
  • Davis B. Horkan
    • 1
  • Marguerite L. Bandeian
    • 1
  • Juan E. Sola
    • 1
  • Charles A. Karcutskie
    • 1
  • Casey Allen
    • 1
  • Eduardo A. Perez
    • 1
  • Edward B. Lineen
    • 1
  • Anthony R. Hogan
    • 1
  • Holly L. Neville
    • 1
  1. 1.DeWitt Daughtry Family Department of Surgery, Division of Pediatric SurgeryUniversity of Miami Miller School of MedicineMiamiUSA

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