Ten Years of All-Terrain Vehicle Injury, Mortality, and Healthcare Costs

Background: All-terrain vehicles (ATVs) are increasing in popularity worldwide. The province of Alberta accounts for 25% of Canadian ATV sales. This study describes the epidemiology, outcomes, and associated healthcare costs for a decade of ATV traumatic injury incidents. Methods: This is a retrospective population based cohort study using two provincial databases: the Alberta Trauma Registry and the Office of the Chief Medical Examiner of Alberta. Data for individuals aged 18 years or older with Injury Severity Score >= 12 or deaths between April 1, 1998, and March 31, 2008 were included. Healthcare costs were extrapolated using figures from a Level I trauma center. Results: ATV incidents resulted in 459 serious trauma cases, 395 trauma center admissions (a total of 4,117 days), and a 17% mortality rate. Postdis-charge care was required for nearly 30% of patients. Male patients aged 18 years to 19 years had the highest incidence (6.5 of 100,000 people). Head, neck, and cervical spine injuries were most common (59%) and predictive of mortality (relative risk [RR], 2.19; interquartile range [IQR], 1.35-3.54; p = 0.001). Vehicle rollovers (RR, 2.75; IQR, 1.13-6.70; p = 0.01), vehicle ejection (RR, 4.18; IQR, 1.70-10.32; p = 0.000), alcohol intake (RR, 2.33; IQR, 1.52-3.56; p = 0.000), helmet use (RR, 1.82; IQR, 1.11-3.02; p = 0.01), and incident location were predictive of mortality. Conclusions: Increasing rates of ATV-related serious trauma and death are described in young males riding without helmets after consuming alcohol. Serious injuries contributed to healthcare costs in excess of $6.5 million USD. Predictors of mortality include rider behaviors and mechanical factors. Prevention should include rider education and industry measures to improve ATV stability.