Factors Influencing the Patterns of Injuries and Outcomes in Car versus Car Crashes Compared to Sport Utility, Van, or Pick-up Truck versus Car Crashes: Crash Injury Research Engineering Network Study

Siegel, John H.; Loo, George; Dischinger, Patricia C.; Burgess, Andrew R.; Wang, Stewart C.; Schneider, Lawrence W.; Grossman, David C.; Rivara, F. P.; Mock, Charles; Natarajan, Geetha; Hutchins, Kenneth D.; Bents, Frances D.; McCammon, Laurie; Leibovich, Esther; Tenenbaum, Nadegda

doi:10.1097/00005373-200111000-00024

Cited by 56 publications

(40 citation statements)

References 15 publications

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“…Fifth, the NTDB lacks information on the speed of motor vehicles at the time of crash; therefore, we could not control for this potential confounder. 16 Future studies should identify the possible effect of speed at the time of impact on the occurrence of PNIs. Sixth, the NTDB does not provide any information on the postacute course of the patients or the percentage of patients who underwent surgical treatment for their PNIs (most of which happens in a delayed fashion).…”

Section: Discussionmentioning

confidence: 99%

Traumatic peripheral nerve injuries in children: epidemiology and socioeconomics

Missios

Bekelis

Spinner

2014

PED

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Object Despite the negative effects of peripheral nerve injuries (PNIs) on long-term population health, their true prevalence among pediatric trauma patients is under debate. The authors investigated the prevalence of PNIs among children involved in trauma and investigated associations between PNIs and several patient characteristics. Methods The authors performed a retrospective cohort study of pediatric trauma patients who were registered in the National Trauma Data Bank from 2009 through 2011 and who fulfilled the study inclusion criteria. They used regression techniques to investigate the association of demographic and socioeconomic factors with the rate of PNIs among these patients. Results Of the 245,470 study patients, 50,211 were involved in motor vehicle crashes, 3380 in motorcycle crashes, 20,491 in bicycle crashes, 18,262 in pedestrian accidents, 26,294 in other crashes (mainly involving all-terrain vehicles and snowmobiles), and 126,832 in falls. The respective prevalence of PNIs was 0.66% for motor vehicle crashes, 1% for motorcycle crashes, 0.38% for bicycle crashes, 0.42% for pedestrian accidents, 0.79% for other crashes, and 0.52% for falls. Multivariate logistic regression analysis demonstrated that the following were associated with an increased incidence of PNIs: increased patient age (OR 1.10, 95% CI 1.01–1.20), higher Injury Severity Score (OR 1.10, 95% CI 1.01–1.20), elevated systolic blood pressure at arrival at the emergency room (OR 1.10, 95% CI 1.01–1.20), and increased number of trauma surgeons at the institution (OR 1.10, 95% CI 1.01–1.20). The following were associated with lower incidence of PNIs: female sex (OR 0.94, 95% CI 0.87–1.02), rural hospitals (OR 0.94, 95% CI 0.87–1.02), and urban nonteaching hospitals (OR 0.94, 95% CI 0.87–1.02). Conclusions PNIs are more common than previously identified for the pediatric trauma population. These injuries are associated with older age and increased severity of the overall injury.

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Section: Discussionmentioning

confidence: 99%

Traumatic peripheral nerve injuries in children: epidemiology and socioeconomics

Missios

Bekelis

Spinner

2014

PED

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“…36,38,40 Compared with frontal collisions, lateral-impact MVCs have been associated with an increase in the odds of death (OR 12.86) and a higher incidence of severe brain and pelvic injuries. 34,36 In our study, we found that lateral-impact collisions did not differ from frontal collisions with respect to either the risk or the severity of neurological injury. The increased protection in lateral-impact MVCs found in this study may be related to the increased deployment of side airbags in more recently manufactured motor vehicles.…”

Section: Discussionmentioning

confidence: 99%

Incidence and mechanism of neurological deficit after thoracolumbar fractures sustained in motor vehicle collisions

Mukherjee¹,

Beck²,

Yoganandan

et al. 2016

SPI

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OBJECT To determine the incidence of and assess the risk factors associated with neurological injury in motor vehicle occupants who sustain fractures of the thoracolumbar spine. METHODS In this study, the authors queried medical, vehicle, and crash data elements from the Crash Injury Research and Engineering Network (CIREN), a prospectively gathered multicenter database compiled from Level I trauma centers. Subjects had fractures involving the T1–L5 vertebral segments, an Abbreviated Injury Scale (AIS) score of ≥ 3, or injury to 2 body regions with an AIS score of ≥ 2 in each region. Demographic parameters obtained for all subjects included age, sex, height, body weight, and body mass index. Clinical parameters obtained included the level of the injured vertebra and the level and type of spinal cord injury. Vehicular crash data included vehicle make, seatbelt type, and usage and appropriate use of the seatbelt. Crash data parameters included the principal direction of force, change in velocity on impact (ΔV), airbag deployment, and vehicle rollover. The authors performed a univariate analysis of the incidence and the odds of sustaining spinal neurological injury associated with major thoracolumbar fractures with respect to the demographic, clinical, and crash parameters. RESULTS Neurological deficit associated with thoracolumbar fracture was most frequent at extremes of age; the highest rates were in the 0- to 10-year (26.7% [4 of 15]) and 70- to 80-year (18.4% [7 of 38]) age groups. Underweight occupants (OR 3.52 [CI 1.055–11.7]) and obese occupants (OR 3.27 [CI 1.28–8.31]) both had higher odds of sustaining spinal cord injury than occupants with a normal body mass index. The highest risk of neurological injury existed in crashes in which airbags deployed and the occupant was not restrained by a seatbelt (OR 2.35 [CI 0.087–1.62]). Reduction in the risk of neurological injuries occurred when 3-point seatbelts were used correctly in conjunction with the deployment of airbags (OR 0.34 [CI 1.3–6.6]) compared with the occupants who were not restrained by a seatbelt and for whom airbags were not deployed. Crashes with a ΔV greater than 50 km/hour had a significantly higher risk of spinal cord injury (OR 3.45 [CI 0.136–0.617]) than those at lower ΔV values. CONCLUSIONS Deployment of airbags was protective against neurological injury only when used in conjunction with 3-point seatbelts. Vehicle occupants who were either obese or underweight, very young or elderly, and those in crashes with a ΔV greater than 50 km/hour were at higher risk of thoracolumbar neurological injury. Neurological injury at thoracic and lumbar levels was associated with multiple factors, including the incidence of fatality, occupant factors such as age and body habitus, energy at impact, and direction of impact. Current vehicle safety technologies are geared toward a normative body morphology and need to be reevaluated for various body morphologies and torso compliances to lower the risk of neurological injury resulting from thoracolumbar fractures.

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“…Initial impact points are often lower extremities, resulting in fractures of the ankle, around the knee, or fracture of the femur. There are many factors that contribute to the amount of force transferred to specific anatomical structures including change in velocity at impact, timing of impact, degree of compartment intrusion, configuration of occupant and safety devices (Siegel et al, 2001;Bansal et al, 2009;Crandall et al, 1998;Nordhoff, 2004;Chong et al, 2007) Change in velocity at time of impact is closely associated with severity of injury as well as incidence of lower extremity injury (Figure 7) (Chong et al, 2007;Dischinger et al, 1998, Rupp & Scheider, 2004. The effect of timing is illustrated in the different degree of injury sustained when knee contact with instrument panel occurs during deceleration when the instrument panel may still be moving forward causing the localized contact velocity to be lower than impacts that occur once the car has stopped moving (Mackay, 1992).…”

Section: Motor Vehicle Collisionmentioning

confidence: 99%

Biomechanics of Musculoskeletal Injury

Gitajn¹,

Rodriguez²

2011

Biomechanics in Applications

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Factors Influencing the Patterns of Injuries and Outcomes in Car versus Car Crashes Compared to Sport Utility, Van, or Pick-up Truck versus Car Crashes: Crash Injury Research Engineering Network Study

Cited by 56 publications

References 15 publications

Traumatic peripheral nerve injuries in children: epidemiology and socioeconomics

Traumatic peripheral nerve injuries in children: epidemiology and socioeconomics

Incidence and mechanism of neurological deficit after thoracolumbar fractures sustained in motor vehicle collisions

Biomechanics of Musculoskeletal Injury

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