To help reduce the number of pedestrians lying on the road suffering fatal or severe injuries as a result of vehicle collisions, we investigated the influencing factors. We conducted an analysis of the records of the Institute for Traffic Accident Research and Data Analysis Japan between 2012 and 2018; we found that 2452 pedestrians lying on the road were involved in collisions (797 fatalities, 784 severely injured, 871 mildly injured). Multivariate logistic regression analysis identified the following as major factors that positively influenced the fatalities: head or neck injuries (odds ratio [OR], 90.221); trunk injuries (OR, 71.040); trucks as offending vehicle (OR, 2.741); collision velocity of 10–20 km/h (OR, 31.794), 20–30 km/h (OR, 2.982), 30–40 km/h (OR, 8.394), 40–50 km/h (OR, 16.831), and >50 km/h (OR, 18.639); and hit-and-run cases (OR, 1.967). The following had a positive influence on severe injuries: trunk injuries (OR, 4.060); collision velocity of 10–20 km/h (OR, 2.540), 20–30 km/h (OR, 3.700), 30–40 km/h (OR, 5.297), 40–50 km/h (OR, 5.719), and ≥50 km/h (OR, 5.244); and hit-and-run cases (OR, 2.628). Decreasing the collision velocity, avoiding collisions to the head and neck or trunk, and preventing hit-and-run cases would be effective in reducing fatal or severe injuries to pedestrians lying on the road.

Purpose To determine the trends with fatally or otherwise injured pedestrians lying on the road and the relationship to hit-and-run incidents in Japan. Methods We extracted data for 2012–2016 from the records of the Institute for Traffic Accident Research and Data Analysis, Japan, a nationwide traffic accident database. All the injured and fatally injured pedestrians were selected. We examined the levels of pedestrian injury, vehicle speed immediately before the collision, whether or not the pedestrian was lying on the road, and hit-and-run incidents. Chi-square test was employed to make a statistical comparison between the two groups. Results The database contained data on 286,383 pedestrian casualties and 7256 fatalities; 8.3% of fatalities (602 persons) and 0.6% of casualties (1827 persons) involved pedestrians lying on the road. The rates of fatalities and severe injuries were significantly higher for pedestrians who were lying on the road than for those who were not. Hit-and-run incidents were evident in 4.0% of casualties and 7.3% of fatalities. The rate of hit-and-run cases was also significantly higher among pedestrians who were lying on the road. Among fatally injured pedestrians not lying on the road, the rates with speeds of ≥30 km/h did not differ significantly between hit-and-run and other cases. However, when the pedestrians were lying on the road, the rate was significantly increased in hit-and-run cases. Conclusion This is the first report to focus on pedestrians lying on the road and being involved in hit-and-run incidents. In addition to preventing hit-and-run incidents, prevention of pedestrians lying on the road could also decrease fatalities.