Older Adult Golf Cart and All-Terrain Vehicle (ATV)–Related Craniofacial Injuries

Abstract

Objectives:

Analyze the etiologies of craniofacial and temporal bone injury in older adults involved in recreational vehicle trauma.

Methods:

A chart review at a level one trauma center from 2000-2012 included 58 patients over 50 years old. Data obtained include the following variables: age, gender, race, mechanism of injury, intoxication, hospital stay, vehicle type, Glasgow coma score (GCS), injury severity score (ISS), and helmet use.

Results:

Of the 58 patients identified, the mean age was 60.5, and the majority were white (90%) and male (78%). Eleven patients (19.3%) had a craniofacial injury (CFI), and two patients (3%) had a temporal bone fracture. The most common CFI was an orbital wall fracture (64%), followed by maxilla (27%) and nasal bone fracture (27%). Patients with a closed head injury are nearly ten times as likely to incur a CFI (P = 0.0346), and those injured while intoxicated are over seven times more likely to have CFI (P = 0.0084). Patients with a temporal bone fracture are more likely to suffer concurrent additional CFI (P = 0.035). There were no statistical differences in the incidence of CFI in relation to age, race, sex, ISS, GCS, or vehicle type. CFI was not a predictor of the length of hospital stay or mortality. Helmet use and mechanism of injury are not related to the incidence of CFI.

Conclusions:

Recreational vehicle trauma is a risk to older patients. Alcohol is a strong risk factor for CFI. For patients with close head injuries and/or a temporal bone fracture, concurrent CFI should be anticipated.