Lawnmowers Versus Children: The Devastation Continues

Mariano Garay, William L. Hennrikus, Joseph Hess, Erik B. Lehman, Douglas G. Armstrong

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: Accidents with lawnmowers can cause mutilating injuries to children. Safety guidelines regarding the use of lawnmowers were promoted by professional organizations beginning in 2001. The Pennsylvania Trauma Systems Foundation maintains a database including all admissions to accredited Levels 1 to 4 trauma centers in the state. The annual rates of admission for children in our state and the severity of injuries subsequent to introduction of safety guidelines have not been reported, to our knowledge. Ride-on lawnmowers have been associated with more severe injuries in children. Questions/purposes: We asked: (1) What was the incidence of hospital admissions for children with lawnmower-related injuries during 2002 to 2013 and did the incidence vary by age? (2) What was the severity of injuries and did the severity vary by age? (3) How often did these injuries result in amputation? (4) What types of lawnmowers were involved? Methods: This was a retrospective study using a statewide trauma registry. We queried the Pennsylvania Trauma Outcome Study database for children 0 to 17 years old admitted to trauma centers in Pennsylvania between January 2002 and January 2014 with injuries resulting from lawnmower-related accidents. All accredited Levels 1 to 4 trauma centers in the state are required to submit their data to the Pennsylvania Trauma Systems Foundation which maintains the Pennsylvania Trauma Outcome Study database. Demographic information, Injury Severity Scores, International Classification of Diseases procedure codes, and injury location codes were recorded. Type of lawnmower was determined from the narratives and was identified in 60% (119/199) of patients. Traumatic and surgical amputations performed during the index hospitalization were included in the analysis. Information on later surgeries was not available. Subjects were stratified by age: 0 to 6, 7 to 12, and 13 to 17 years old. Results: The incidence of lawnmower injuries in Pennsylvania was a median five of 100,000 children (range, 4–12/100,000) during the study period. The median age was 6 years (range, 1–17 years). The median Injury Severity Score was 4 (range, 1–75). Children 0 to 6 years old had higher median Injury Severity Scores (median, 8; range, 1–75) compared with those 13–17 years old (median, 4; range, 1–20; difference of the medians, 4; p < 0.001). A total of 53% of the patients (106/199) underwent at least one amputation. There were 83 amputations in or of the foot, 18 in the leg, 14 in the hand, and three in the arm. Ride-on lawnmowers accounted for 92% (110/119) of mowers identified by type. Conclusions: The incidence of serious injuries to children owing to lawnmower-related trauma did not change during the 12-year study period. If children younger than 6 years had not been near the lawnmower and those younger than 12 years had not been operating one, at least 69% of the accidents might have been prevented. We recommend annual publicity campaigns during spring to remind the public of the dangers of lawnmowers to children. Level of Evidence: Level IV, therapeutic study.

Original languageEnglish (US)
Pages (from-to)950-956
Number of pages7
JournalClinical orthopaedics and related research
Volume475
Issue number4
DOIs
StatePublished - Apr 1 2017

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Wounds and Injuries
Injury Severity Score
Trauma Centers
Amputation
Accidents
Incidence
Databases
Traumatic Amputation
Outcome Assessment (Health Care)
Guidelines
Safety
International Classification of Diseases
Registries
Foot
Leg
Hospitalization
Arm
Retrospective Studies
Hand
Demography

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

@article{ba81975d3005470196990e6ba31de599,
title = "Lawnmowers Versus Children: The Devastation Continues",
abstract = "Background: Accidents with lawnmowers can cause mutilating injuries to children. Safety guidelines regarding the use of lawnmowers were promoted by professional organizations beginning in 2001. The Pennsylvania Trauma Systems Foundation maintains a database including all admissions to accredited Levels 1 to 4 trauma centers in the state. The annual rates of admission for children in our state and the severity of injuries subsequent to introduction of safety guidelines have not been reported, to our knowledge. Ride-on lawnmowers have been associated with more severe injuries in children. Questions/purposes: We asked: (1) What was the incidence of hospital admissions for children with lawnmower-related injuries during 2002 to 2013 and did the incidence vary by age? (2) What was the severity of injuries and did the severity vary by age? (3) How often did these injuries result in amputation? (4) What types of lawnmowers were involved? Methods: This was a retrospective study using a statewide trauma registry. We queried the Pennsylvania Trauma Outcome Study database for children 0 to 17 years old admitted to trauma centers in Pennsylvania between January 2002 and January 2014 with injuries resulting from lawnmower-related accidents. All accredited Levels 1 to 4 trauma centers in the state are required to submit their data to the Pennsylvania Trauma Systems Foundation which maintains the Pennsylvania Trauma Outcome Study database. Demographic information, Injury Severity Scores, International Classification of Diseases procedure codes, and injury location codes were recorded. Type of lawnmower was determined from the narratives and was identified in 60{\%} (119/199) of patients. Traumatic and surgical amputations performed during the index hospitalization were included in the analysis. Information on later surgeries was not available. Subjects were stratified by age: 0 to 6, 7 to 12, and 13 to 17 years old. Results: The incidence of lawnmower injuries in Pennsylvania was a median five of 100,000 children (range, 4–12/100,000) during the study period. The median age was 6 years (range, 1–17 years). The median Injury Severity Score was 4 (range, 1–75). Children 0 to 6 years old had higher median Injury Severity Scores (median, 8; range, 1–75) compared with those 13–17 years old (median, 4; range, 1–20; difference of the medians, 4; p < 0.001). A total of 53{\%} of the patients (106/199) underwent at least one amputation. There were 83 amputations in or of the foot, 18 in the leg, 14 in the hand, and three in the arm. Ride-on lawnmowers accounted for 92{\%} (110/119) of mowers identified by type. Conclusions: The incidence of serious injuries to children owing to lawnmower-related trauma did not change during the 12-year study period. If children younger than 6 years had not been near the lawnmower and those younger than 12 years had not been operating one, at least 69{\%} of the accidents might have been prevented. We recommend annual publicity campaigns during spring to remind the public of the dangers of lawnmowers to children. Level of Evidence: Level IV, therapeutic study.",
author = "Mariano Garay and Hennrikus, {William L.} and Joseph Hess and Lehman, {Erik B.} and Armstrong, {Douglas G.}",
year = "2017",
month = "4",
day = "1",
doi = "10.1007/s11999-016-5132-5",
language = "English (US)",
volume = "475",
pages = "950--956",
journal = "Clinical Orthopaedics and Related Research",
issn = "0009-921X",
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}

Lawnmowers Versus Children : The Devastation Continues. / Garay, Mariano; Hennrikus, William L.; Hess, Joseph; Lehman, Erik B.; Armstrong, Douglas G.

In: Clinical orthopaedics and related research, Vol. 475, No. 4, 01.04.2017, p. 950-956.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Lawnmowers Versus Children

T2 - The Devastation Continues

AU - Garay, Mariano

AU - Hennrikus, William L.

AU - Hess, Joseph

AU - Lehman, Erik B.

AU - Armstrong, Douglas G.

PY - 2017/4/1

Y1 - 2017/4/1

N2 - Background: Accidents with lawnmowers can cause mutilating injuries to children. Safety guidelines regarding the use of lawnmowers were promoted by professional organizations beginning in 2001. The Pennsylvania Trauma Systems Foundation maintains a database including all admissions to accredited Levels 1 to 4 trauma centers in the state. The annual rates of admission for children in our state and the severity of injuries subsequent to introduction of safety guidelines have not been reported, to our knowledge. Ride-on lawnmowers have been associated with more severe injuries in children. Questions/purposes: We asked: (1) What was the incidence of hospital admissions for children with lawnmower-related injuries during 2002 to 2013 and did the incidence vary by age? (2) What was the severity of injuries and did the severity vary by age? (3) How often did these injuries result in amputation? (4) What types of lawnmowers were involved? Methods: This was a retrospective study using a statewide trauma registry. We queried the Pennsylvania Trauma Outcome Study database for children 0 to 17 years old admitted to trauma centers in Pennsylvania between January 2002 and January 2014 with injuries resulting from lawnmower-related accidents. All accredited Levels 1 to 4 trauma centers in the state are required to submit their data to the Pennsylvania Trauma Systems Foundation which maintains the Pennsylvania Trauma Outcome Study database. Demographic information, Injury Severity Scores, International Classification of Diseases procedure codes, and injury location codes were recorded. Type of lawnmower was determined from the narratives and was identified in 60% (119/199) of patients. Traumatic and surgical amputations performed during the index hospitalization were included in the analysis. Information on later surgeries was not available. Subjects were stratified by age: 0 to 6, 7 to 12, and 13 to 17 years old. Results: The incidence of lawnmower injuries in Pennsylvania was a median five of 100,000 children (range, 4–12/100,000) during the study period. The median age was 6 years (range, 1–17 years). The median Injury Severity Score was 4 (range, 1–75). Children 0 to 6 years old had higher median Injury Severity Scores (median, 8; range, 1–75) compared with those 13–17 years old (median, 4; range, 1–20; difference of the medians, 4; p < 0.001). A total of 53% of the patients (106/199) underwent at least one amputation. There were 83 amputations in or of the foot, 18 in the leg, 14 in the hand, and three in the arm. Ride-on lawnmowers accounted for 92% (110/119) of mowers identified by type. Conclusions: The incidence of serious injuries to children owing to lawnmower-related trauma did not change during the 12-year study period. If children younger than 6 years had not been near the lawnmower and those younger than 12 years had not been operating one, at least 69% of the accidents might have been prevented. We recommend annual publicity campaigns during spring to remind the public of the dangers of lawnmowers to children. Level of Evidence: Level IV, therapeutic study.

AB - Background: Accidents with lawnmowers can cause mutilating injuries to children. Safety guidelines regarding the use of lawnmowers were promoted by professional organizations beginning in 2001. The Pennsylvania Trauma Systems Foundation maintains a database including all admissions to accredited Levels 1 to 4 trauma centers in the state. The annual rates of admission for children in our state and the severity of injuries subsequent to introduction of safety guidelines have not been reported, to our knowledge. Ride-on lawnmowers have been associated with more severe injuries in children. Questions/purposes: We asked: (1) What was the incidence of hospital admissions for children with lawnmower-related injuries during 2002 to 2013 and did the incidence vary by age? (2) What was the severity of injuries and did the severity vary by age? (3) How often did these injuries result in amputation? (4) What types of lawnmowers were involved? Methods: This was a retrospective study using a statewide trauma registry. We queried the Pennsylvania Trauma Outcome Study database for children 0 to 17 years old admitted to trauma centers in Pennsylvania between January 2002 and January 2014 with injuries resulting from lawnmower-related accidents. All accredited Levels 1 to 4 trauma centers in the state are required to submit their data to the Pennsylvania Trauma Systems Foundation which maintains the Pennsylvania Trauma Outcome Study database. Demographic information, Injury Severity Scores, International Classification of Diseases procedure codes, and injury location codes were recorded. Type of lawnmower was determined from the narratives and was identified in 60% (119/199) of patients. Traumatic and surgical amputations performed during the index hospitalization were included in the analysis. Information on later surgeries was not available. Subjects were stratified by age: 0 to 6, 7 to 12, and 13 to 17 years old. Results: The incidence of lawnmower injuries in Pennsylvania was a median five of 100,000 children (range, 4–12/100,000) during the study period. The median age was 6 years (range, 1–17 years). The median Injury Severity Score was 4 (range, 1–75). Children 0 to 6 years old had higher median Injury Severity Scores (median, 8; range, 1–75) compared with those 13–17 years old (median, 4; range, 1–20; difference of the medians, 4; p < 0.001). A total of 53% of the patients (106/199) underwent at least one amputation. There were 83 amputations in or of the foot, 18 in the leg, 14 in the hand, and three in the arm. Ride-on lawnmowers accounted for 92% (110/119) of mowers identified by type. Conclusions: The incidence of serious injuries to children owing to lawnmower-related trauma did not change during the 12-year study period. If children younger than 6 years had not been near the lawnmower and those younger than 12 years had not been operating one, at least 69% of the accidents might have been prevented. We recommend annual publicity campaigns during spring to remind the public of the dangers of lawnmowers to children. Level of Evidence: Level IV, therapeutic study.

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