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The study examined the association of vehicle seating positions with the risk of death in serious motor vehicle crashes (MVCs) in Japan. Methods: Data from the Japan Trauma Data Bank between 2004 and 2015 were analyzed. All MVC drivers with the legal age for driving and all copassengers were enrolled (n = 23,040). The cases were divided into three groups based on their seating position during the crash: the driver seat, front passenger seat, and rear passenger seats. The primary outcome variable was in-hospital mortality. Multivariable logistic regression analysis was used to assess the association between the seating position and in-hospital mortality. Potential factors associated with each seating position and in-hospital mortality were also assessed. Results: The odds ratios (ORs) for deaths were estimated for front and rear passengers compared to those for the driver in MVCs. The adjusted ORs (95% confidence interval [CI]) for death were 0.96 (0.84-1.11) and 1.22 (1.04-1.42) for front and rear passengers, respectively. Factors significantly associated with MVC deaths were age over 71 years (

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