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Abstract
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BACKGROUND: Motocross-related injury patterns and outcomes are poorly understood. The purpose of this analysis was to characterize the epidemiology, injury patterns, and outcomes of motocross collisions. These parameters were compared to motorcycle collisions for context.
METHODS: The NTDB (2007-14) was utilized to identify and compare injured motorcycle and motocross riders. Variables extracted were demographics, AIS for each body area, ISS, and ED vital signs. Outcomes included mortality, ventilation days, ICU Length of Stay (LOS), and hospital LOS.
RESULTS: Of the 5,774,836 NTDB patients, 141,529 were involved in motocross or motorcycle collisions (31,252 motocross and 110,277 motorcycle). Overall, 94.4% were drivers and 87.4% were male. Motocross riders were younger (23 vs. 42, p<0.001), more likely to use helmets (68.9% vs. 54.1%, p<0.001), and less likely to have used alcohol (8.4% vs. 23.0%, p<0.001). Head and chest injuries were less common in motocross patients (28.6% vs. 37.2%, p<0.001; 25.5% vs. 37.7%, p<0.001, respectively), as were ISS>15 and GCS≤8 (18.2% vs. 28.1%, p<0.001; 3.7% vs. 7.7%, p<0.001, respectively). Overall mortality was significantly lower in the motocross group (0.3% vs. 1.4%, p<0.001). Stepwise logistic regression analysis identified age>60, GCS≤8, hypotension on admission, head AIS≥3, and riding a motorcycle, either as a driver or passenger, to be independent predictors of mortality. Subgroup analysis revealed being a motocross driver or passenger to be an independent predictor of improved survival (OR 0.458; 95% CI, 0.359-0.585; p<0.001 and OR 0.127; CI 95%, 0.017-0.944; p=0.044, respectively). Helmets were protective against mortality for all patients (OR 0.866; 95% CI, 0.755-0.992; p=0.039).
CONCLUSIONS: Motocross and motorcycle collisions are distinct mechanisms of injury. Motocross riders are younger, more likely to wear protective devices, and less likely to use alcohol. Motocross collisions are associated with better outcomes compared to motorcycle collisions. Wearing a helmet is associated with improved survival for all riders. LEVEL OF EVIDENCE: Level IV, Retrospective Epidemiological Study.
Language: en |