Risk factors for serious injury to child occupants 0-3 years in motor vehicle crashes

There has been no detailed review of injury outcome among children younger than 3 since 1994. While observational studies indicate age-appropriate restraint use is high in this age group, there have been significant design changes to the restraint systems used by these children over this period.
This study examines the relationship between crash factors, restraint status and outcome for children aged 0-3 who have been injured in car crashes in NSW. To achieve this, all children attending the Children’s Hospital at Westmead subsequent to a motor vehicle crash between 2001 and 2011 were identified. Cases involving fatal injury were identified through the Department of Forensic Medicine. Data was extracted from narratives within medical records and analysed using descriptive and logistic regression techniques.
Data was collected for 90 children aged 1-35 months (mean 15 months). ISS scores ranged from 0-75 (mean 8.3) and included 13 children who were fatally injured. Restraint use was reported in all but one of the fatally injured children and 80% of the seriously injured (ISS >8). It was not possible to distinguish between rearward-facing and forward-facing restraint use from the available data, however over 20% of the children with ISS >8 used a booster seat or adult seat belt. The likelihood of serious injury is increased in motor vehicle crashes that occur in rural locations. There is a need for a more detailed study to examine restraint factors influencing outcome in children of this age.