Factors influencing vehicle passenger fatality have changed over 10 years: a nationwide hospital-based study

Abstract

Traffic injury trends have changed with safety developments. To establish effective preventive measures against traffic fatalities, the factors influencing fatalities must be understood. The present study evaluated data from a national medical database to determine the changes in these factors over time, as this has not been previously investigated. This observational study retrospectively analysed data from the Japanese Trauma Data Bank. Vehicle passengers involved in collisions from 2004-2008 and 2016-2017 were included. Data were compared between the two study periods, and between fatal and non-fatal patients within each period. Multivariate logistic regression analyses were performed to determine the factors influencing fatalities. In 2016-2017, patients were older and had lower fatality rates. In 2004-2008, fatalities were more likely to involve older male front-seat passengers with low d-BP, BT, and GCS values, and high AIS of the neck and abdomen. However, in 2016-2017, fatalities were more likely to involve older males with low GCS, high AIS of the abdomen, and positive focused assessment with sonography for trauma results. Our study identified independent factors influencing vehicle passenger fatalities, which will likely continue to evolve with the aging of the population and changing manners of injury.

Factors Affecting Death and Severe Injury in Child Motor Vehicle Passengers

“…With regard to vital signs in passengers, our results suggest that a lower BT was significantly associated with the fatality rate. This finding is similar to that found in adults who were examined between 2004 and 2008 [5]. Therefore, measuring BT in patients would be useful for estimating the prognosis.…”

“…This difference between studies is likely because of the difference in the distribution of the seating position between children and adults. Most child passengers sat in the rear seat in the present study, whereas more than three-quarters of adult vehicle passengers sat in the driver's seat in the previous study [5].…”

“…A previous study on adult vehicle passengers aged ≥ 15 years investigated factors affecting fatality using a similar database to the JTDB. Between 2016 and 2017, the factors of male sex (OR: 2.49), being a front-seat passenger (OR: 1.99), age (OR: 1.05), the GCS score (OR: 0.77), the AIS score of the abdomen (OR: 1.40), and FAST positivity (OR: 2.40) were identified as independent predictors of fatality [5]. In the present study, a similar trend was found for the GCS score, but there were some differences compared with this other study.…”

“…The burden of injury and death from MVCs is disproportionately borne by vulnerable road users such as children. With the improvement of vehicle safety equipment, laws of seat belt use, improvement of prehospital and trauma care, and education on trauma critical care, the mortality rate of motor vehicle passengers in MVCs has been decreasing in Japan [2][3][4][5]. However, MVC injury is currently the leading cause of death in children and young adults aged 5 to 29 years [1].…”

Predictive Factors of Severe Abdominal Injuries Due to Seatbelt Compression in Motor Vehicle Passengers

“…This fact is substantially due to seatbelt-induced abdominal injuries. A recent study based on nationwide hospital data suggested that the AIS score of the abdomen was the single signi cant in uencing factor for fatalities of motor vehicle passengers [19]. The authors also suggested that seatbelt compression might somewhat contribute to the occurrence of abdominal organ injuries.…”