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Preventing pediatric backover trauma: The impact of a federally mandated car safety feature.

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Τίτλος: Preventing pediatric backover trauma: The impact of a federally mandated car safety feature.
Συγγραφείς: Joly JM; Department of Pediatric Surgery, McGovern Medical School at UTHealth Houston and Children's Memorial Hermann Hospital, Houston, TX, USA; Center for Surgical Trials and Evidence-Based Practice (CSTEP), McGovern Medical School at UTHealth Houston, Houston, TX, USA. Electronic address: https://twitter.com/@jeannettemjoly., Sutyak KM; Department of Pediatric Surgery, McGovern Medical School at UTHealth Houston and Children's Memorial Hermann Hospital, Houston, TX, USA; Center for Surgical Trials and Evidence-Based Practice (CSTEP), McGovern Medical School at UTHealth Houston, Houston, TX, USA. Electronic address: https://twitter.com/@ksutyak., Jayarajan NG; Department of Pediatric Surgery, McGovern Medical School at UTHealth Houston and Children's Memorial Hermann Hospital, Houston, TX, USA., Mina A; Department of Pediatric Surgery, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA., Morris EM; Department of Pediatric Surgery, McGovern Medical School at UTHealth Houston and Children's Memorial Hermann Hospital, Houston, TX, USA; Center for Surgical Trials and Evidence-Based Practice (CSTEP), McGovern Medical School at UTHealth Houston, Houston, TX, USA., Miller CC; Department of Cardiothoracic and Vascular Surgery, McGovern Medical School at UTHealth Houston, Houston, TX, USA., Rollins-Reis A; Kids and Car Safety, Philadelphia, PA, USA. Electronic address: https://twitter.com/@KidsAndCars., Fennell JE; Kids and Car Safety, Philadelphia, PA, USA. Electronic address: https://twitter.com/@KidsAndCars., Pryor HI; Department of Pediatric Surgery, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA., Tsao K; Department of Pediatric Surgery, McGovern Medical School at UTHealth Houston and Children's Memorial Hermann Hospital, Houston, TX, USA; Center for Surgical Trials and Evidence-Based Practice (CSTEP), McGovern Medical School at UTHealth Houston, Houston, TX, USA. Electronic address: https://twitter.com/@KuoJenTsao., Lally KP; Department of Pediatric Surgery, McGovern Medical School at UTHealth Houston and Children's Memorial Hermann Hospital, Houston, TX, USA; Center for Surgical Trials and Evidence-Based Practice (CSTEP), McGovern Medical School at UTHealth Houston, Houston, TX, USA. Electronic address: https://twitter.com/@UTH_Pedisurg., Drucker NA; Department of Pediatric Surgery, McGovern Medical School at UTHealth Houston and Children's Memorial Hermann Hospital, Houston, TX, USA; Center for Surgical Trials and Evidence-Based Practice (CSTEP), McGovern Medical School at UTHealth Houston, Houston, TX, USA. Electronic address: Natalie.a.drucker@uth.tmc.edu.
Πηγή: Journal of pediatric surgery [J Pediatr Surg] 2026 Oct; Vol. 61 (10), pp. 163303. Date of Electronic Publication: 2026 Jul 17.
Τύπος έκδοσης: Journal Article; Observational Study
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Saunders Country of Publication: United States NLM ID: 0052631 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1531-5037 (Electronic) Linking ISSN: 00223468 NLM ISO Abbreviation: J Pediatr Surg Subsets: MEDLINE
Imprint Name(s): Publication: Philadelphia, PA : Saunders
Original Publication: New York.
Ιατρικοί όροι (MeSH): Wounds and Injuries*/prevention & control , Wounds and Injuries*/epidemiology , Accidents, Traffic*/prevention & control , Accidents, Traffic*/statistics & numerical data , Accidents, Traffic*/legislation & jurisprudence , Automobiles*/legislation & jurisprudence , Automobiles*/standards, United States/epidemiology ; Humans ; Retrospective Studies ; Child, Preschool ; Female ; Registries ; Infant ; Male ; Trauma Centers ; Incidence ; Pedestrians
Περίληψη: Purpose: Backover trauma occurs when a reversing motorized vehicle strikes a pedestrian, often a small child. Injuries carry significant morbidity and mortality. A federal mandate required newly manufactured motor vehicles to meet a rear visibility standard by May 2018. This study characterizes the mandate's impact on pediatric backover trauma.
Methods: A retrospective pre-post observational study was conducted of children (<5 years) with backover trauma (01/2011-11/2024). Two datasets were utilized: trauma registries from two Level I pediatric trauma centers serving a single catchment area, and case lists curated by Kids and Car Safety (KACS) from publicly available injury reports (same region). Univariate analyses and Poisson/quasi-Poisson models compared backover rates and incidences, pre-mandate versus post-mandate.
Results: From trauma registry data, 120 patients were identified: 85 pre-mandate, 35 post-mandate. Patients were median 2.1 years old (IQR: 1.6-2.8) and 65% male. Median ISS was 10.0 (IQR: 5.0-17.3) with no difference between groups (p = 0.68), but fewer severe injuries occurred post-mandate (12 pre-mandate, 5 post-mandate). Backover injury rate decreased from 11.6/year pre-mandate to 5.3/year post-mandate (RR: 0.46; 95% CI: 0.28-0.75), and incidence decreased from 17.3 to 7.1 per 100,000 (Incidence RR: 0.41; 95% CI: 0.27-0.60). From KACS data, 28 victims were identified: 22 pre-mandate, 6 post-mandate. Backover injury rate was higher pre-mandate (3.0/year) and decreased post-mandate to 0.9/year (RR: 0.30; 95% CI: 0.12-0.75). Fatalities decreased from 18 (82%) pre-mandate to 4 (67%) post-mandate (p = 0.58).
Conclusion: Pediatric backover rates decreased following full compliance with the federal mandate. Fewer severe injuries occurred, and publicly reported fatalities decreased by 78%. Reduced rate, incidence, and severity of backover injuries justify public health-driven regulatory requirements.
(Copyright © 2026 Elsevier Inc. All rights reserved.)
Competing Interests: Declaration of interests The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Contributed Indexing: Keywords: Backover; Federal mandate; Injury prevention; Motor vehicle collision; Pedestrian trauma; Pediatric trauma; Public health
Entry Date(s): Date Created: 20260717 Date Completed: 20260911 Latest Revision: 20260916
Update Code: 20260916
DOI: 10.1016/j.jpedsurg.2026.163303
PMID: 42468686
Βάση Δεδομένων: MEDLINE
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  Data: Purpose: Backover trauma occurs when a reversing motorized vehicle strikes a pedestrian, often a small child. Injuries carry significant morbidity and mortality. A federal mandate required newly manufactured motor vehicles to meet a rear visibility standard by May 2018. This study characterizes the mandate&#39;s impact on pediatric backover trauma.&lt;br /&gt;Methods: A retrospective pre-post observational study was conducted of children (&amp;lt;5 years) with backover trauma (01/2011-11/2024). Two datasets were utilized: trauma registries from two Level I pediatric trauma centers serving a single catchment area, and case lists curated by Kids and Car Safety (KACS) from publicly available injury reports (same region). Univariate analyses and Poisson/quasi-Poisson models compared backover rates and incidences, pre-mandate versus post-mandate.&lt;br /&gt;Results: From trauma registry data, 120 patients were identified: 85 pre-mandate, 35 post-mandate. Patients were median 2.1 years old (IQR: 1.6-2.8) and 65% male. Median ISS was 10.0 (IQR: 5.0-17.3) with no difference between groups (p = 0.68), but fewer severe injuries occurred post-mandate (12 pre-mandate, 5 post-mandate). Backover injury rate decreased from 11.6/year pre-mandate to 5.3/year post-mandate (RR: 0.46; 95% CI: 0.28-0.75), and incidence decreased from 17.3 to 7.1 per 100,000 (Incidence RR: 0.41; 95% CI: 0.27-0.60). From KACS data, 28 victims were identified: 22 pre-mandate, 6 post-mandate. Backover injury rate was higher pre-mandate (3.0/year) and decreased post-mandate to 0.9/year (RR: 0.30; 95% CI: 0.12-0.75). Fatalities decreased from 18 (82%) pre-mandate to 4 (67%) post-mandate (p = 0.58).&lt;br /&gt;Conclusion: Pediatric backover rates decreased following full compliance with the federal mandate. Fewer severe injuries occurred, and publicly reported fatalities decreased by 78%. Reduced rate, incidence, and severity of backover injuries justify public health-driven regulatory requirements.&lt;br /&gt; (Copyright &#169; 2026 Elsevier Inc. All rights reserved.)
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