Factors influencing pediatric Injury Severity Score and Glasgow Coma Scale in pediatric automobile crashes: results from the Crash Injury Research Engineering Network Peter F. Ehrlich a, * , J. Kristine Brown a , Mark R. Sochor b , Stewart C. Wang c , Martin E. Eichelberger d a Department of Surgery, Section of Pediatric Surgery, University of Michigan, Ann Arbor, MI, USA b Department of Emergency, Medicine University of Michigan, Ann Arbor, MI, USA c Department of Surgery, Section of Trauma Surgery, University of Michigan, Ann Arbor, MI, USA d Department of Surgery, Section of Pediatric Surgery, Children’s National Medical Center, Washington, DC, USA Abstract Background/Purpose: Motor vehicle crashes account for more than 50% of pediatric injuries. Triage of pediatric patients to appropriate centers can be based on the crash/injury characteristics. Pediatric motor vehicle crash/injury characteristics can be determined from an in vitro laboratory using child crash dummies. However, to date, no detailed data with respect to outcomes and crash mechanism have been presented with a pediatric in vivo model. Methods: The Crash Injury Research Engineering Network is comprised of 10 level 1 trauma centers. Crashes were examined with regard to age, crash severity (DV), crash direction, restraint use, and airbag deployment. Multiple logistic regression analysis was performed with Injury Severity Score (ISS) and Glasgow Coma Scale (GCS) as outcomes. Standard age groupings (0 - 4, 5-9, 10-14, and 15-18) were used. The database is biased toward a survivor population with few fatalities. Results: Four hundred sixty-one motor vehicle crashes with 2500 injuries were analyzed (242 boys, 219 girls). Irrespective of age, DV N 30 mph resulted in increased ISS and decreased GCS (eg, for 0-4 years, DV b 30: ISS = 10, GCS = 13.5 vs DV N 30: ISS = 19.5, GCS = 10.6; P b .007, b .002, respectively). Controlling for DV , children in lateral crashes had increased ISS and decreased GCS versus those in frontal crashes. Airbag deployment was protective for children 15 to 18 years old and resulted in a lower ISS and higher GCS (odds ratio, 2.1; 95% confidence interval, 0.9-4.6). Front-seat passengers suffered more severe (ISS N 15) injuries than did backseat passengers (odds ratio, 1.7; 95% confidence interval, 0.7-3.4). A trend was noted for children younger than 12 years sitting in the front seat to have increased ISS and decreased GCS with airbag deployment but was limited by case number. 0022-3468/$ – see front matter D 2006 Elsevier Inc. All rights reserved. doi:10.1016/j.jpedsurg.2006.06.012 * Corresponding author. Tel.: +1 734 764 5545; fax: +1 734 936 9784. E-mail address: pehrlich@med.umich.edu (P.F. Ehrlich). Index words: Pediatric trauma; Motor vehicle crashes; Injury Severity Score; Glasgow Coma Scale Journal of Pediatric Surgery (2006) 41, 1854 – 1858 www.elsevier.com/locate/jpedsurg