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Lack of golf cart guidelines pose serious injury risk to children

CHICAGO — Although severe pediatric injuries resulting from the use of all-terrain vehicles – such as skull fractures, concussions and intracranial hemorrhages – prompted the AAP to establish guidelines prohibiting their use, there are no guidelines in place for the use of golf carts that pose similar risks to children.

“Just because golf carts don’t usually reach speeds other recreational vehicles can, this doesn't mean they are harmless,” researcher Mariano Garay, MD, from the Penn State College of Medicine said in a press release.

Between Jan. 1, 2004, and Dec. 31, 2014, 108 patients at these trauma centers met the criteria for the study, with 0.36 cases per 100,000 patients (range: 0.18-0.47/100,000). Patients included had a median age of 11 years, and a median hospital stay of 2 days (range: 1-26 days).

Although the median injury severity score equaled 9.5 (range: 1-30), there was no significant difference in score based on age. Children who were younger (between 0 and 5 years) had a median length of stay of 1 day (P = .01), which was less than that of children who were aged 12 to 15 years (3 days; P = .009). ICU admissions were necessary for 36% of cases. Although statistically insignificant, those between 6 and 11 years (OR 3.3), 12 and 15 years (OR 3.1) and 16 and 17 years (OR 2.0) were more likely to be admitted to the ICU (P = .29).

Most patients included in the study fractured at least one bone (76%), and skull fractures were more common than fractures of the extremities (44% vs. 27%). Fractures were most common in children aged 6 to 11 (OR 0.29), 12 to 15 (OR 0.46) and 16 to 17 (OR 0.53) (P = .39), and concussions were sustained by 27% of children. Intracranial injuries were observed in 25% of patients. Additionally, intracranial hemorrhages were observed in 30% of patients included in the study. One child died as a result of golf cart-related injuries.

Fracture, intracranial injury and concussion rates were not significantly varied by age group or sex, although children between the ages of 6 and 11 years were more likely to become concussed than those between the ages of 0 to 5 years (OR 1.7, 95% CI [0.46-6.1]).

“We recommend that children under 16 years old not drive the golf cart at all,” researcher William Hennrikus, MD, FAAP, pediatric orthopedic surgeon in Hershey, Pa., said in press release, “and when golf carts are used, they should be driven at cautious speeds, under 10 miles per hour.” –by Katherine Bortz

Reference:

Garay M, et al. Golf carts and children: An 11-year single state experience. Presented at: 2017 AAP National Conference & Exhibition; Sept. 16-19; Chicago.

Disclosure: Infectious Diseases in Children could not obtain disclosure information before publication.