Annual proceedings. Association for the Advancement of Automotive Medicine最新文献

Hypothesis: A second injury in the same body region is associated with lower mortality than a second injury in a different body region, independently of injury severity and body region.

Methods: The population consisted of 15,200 patients with two or more injuries from level I trauma centers in Quebec. The mortality odds ratio of having a same-region second injury (SR) as opposed to a different-region second injury (DR) was assessed.

Results: Patients with a SR had 43% lower odds of mortality when compared to patients with a DR.

Conclusion: A second injury in the same body region is associated with lower mortality than a second injury in a different body region.

Using data from i) a self-administered survey of 673 older female drivers, and ii) a case-control study of 48 crash-involved and 44 non crash-involved older female drivers, some factors that may predict crash involvement were identified. Survey data gathered self-reported information on demographic characteristics, health status, travel patterns and driving practices. A battery of functional performance assessments were administered by trained experimenters in the case-control study, and participants completed a second detailed self-administered questionnaire. Factors found to predict crash involvement included driving characteristics such as being the main driver in the household, not highly confident of being a safe driver, experiencing difficulty driving in unfamiliar areas and having problems with the driving style of other drivers. In addition, low attentional, cognitive and motor skills and presence of multiple medical conditions were significant predictors of crash involvement.

Field data on side airbag deployments in lateral crashes and head injuries have largely remained anecdotal. Consequently, the purpose of this research was to report head injuries in lateral motor vehicle impacts. Data from the National Automotive Sampling System files were extracted from side impacts associated with side airbag deployments. Matched pairs with similar vehicle characteristics but without side airbags were also extracted. All data were limited to the United States Federal Motor vehicle Safety Standards FMVSS 214 compliant vehicles so that the information may be more effectively used in the future. In this study, some fundamental analyses are presented regarding occupant- and vehicle-related parameters.

Pre-hospital care in developing worlds has been found to be grossly deficient compared to high income countries. The pre-hospital care given to road accident victims attending the casualty departments of four tertiary level hospitals in South Western Nigeria was assessed using a one-page pro-forma. 1996 patients with injuries from road crashes were seen in the hospitals, only 172 had any form of pre-hospital care, just 160 were transported in ambulances and none had any form of organized pre-hospital care. The mean arrival time in the hospital after crashes was 93.6 minutes and there was a high rate (29.5%) of inter-hospital referral. For every Revised Trauma Score (RTS), the Probability of survival (Ps) of the patients was higher than the Ps of patients from high income countries.

While there is a great deal of data documenting the etiologic role alcohol use plays in crash culpability, there is a dearth of data for other drugs. The purpose of this study was to assess crash culpability for single drug use among injured drivers admitted to a regional trauma center. This study is the largest of its kind involving trauma center patients. Clinical toxicology results obtained for patient care were linked to police crash reports containing a field attributing crash culpability. Drugs studied were alcohol, cocaine, and marijuana. As expected crash culpability was strongly associated with pre-crash alcohol use. In contrast, for both men and women, this study did not find an association between crash culpability and marijuana use. The data documents a significant association between cocaine use and crash culpability for both sexes and for drivers 21 to 40 years of age. This is the first large study to assess for crash culpability among injured drivers relative to cocaine use. Each year approximately 42 to 43,000 people die annually as the result of vehicular crashes. (NHTSA, 2005) For the decade 1994 through 2003, alcohol was a factor in 40-43% fatal injury crashes - the fatally injured person being either a vehicular occupant or pedestrian. Specifically 25 to 29% of drivers of cars and light trucks involved in those crashes were alcohol positive. Further, it is estimated that 80% or more of those drivers had blood alcohol concentrations (BAC) of 80 mg/dl or greater. (NHTSA, 2005).

Recent studies have shown that survivors of road traffic crashes experience significant psychological health difficulties. Perception of another party as being responsible for the occurrence of a crash has been associated with on-going distress and lower psychological well-being. This paper extends this research by examining the influence of perceived crash responsibility on depression severity. A total of 57 adults aged 18-58 years injured in a road traffic crash were interviewed prior to hospital discharge and at 2-months post-crash. The results indicate that perceiving oneself as being responsible for the crash is associated with higher levels of later depression compared to those where responsibility is perceived to be shared, and to a lesser extent compared to those perceiving another party as being responsible. Persistent pain and pre-crash psychological health were found to be strongly associated with later depression severity, while trends indicate that length of stay beyond 7 days in hospital is also an important predictor. These findings are discussed in the context of past research.

The number of rolls, as well as other factors, has been associated with increased injury risk in rollovers. Data from NASS-CDS from 1995-2003 were used to evaluate the biomechanical implications of vehicle kinematics during multiple rolls and to evaluate the risk of injuries to different body regions during rollovers. The data showed that the risk of injury increased with increasing number of rolls. The rate of increase in risk varied by the region of the body affected and injury severity. The increased risk was particularly great when a vehicle rolled more than two complete rolls.

With the vehicle fleet of family transportation in the United States continuing to evolve primarily through the increasing number of light truck vehicles (LTV), studying the effects of vehicle incompatibility has become increasingly important. Using data collected from a population-based sample of child-involved crashes in insured vehicles, we explored the effect of variations in crash partner vehicle type on child occupant injury risk, stratified by direction of impact. Children in passenger cars and LTVs involved in onside collisions were at an increased risk of serious injury if struck by a LTV as compared to a passenger vehicle (passenger cars and minivans). Though smaller in magnitude, this trend was also present in offside and rear crashes as well.

This study investigates injury occurrence for belted occupants as a function of age. An analysis of NASS/CDS 1997-2003 data was conducted to determine crash involvement rates and injury rates for front seat occupants versus mean occupant age. In frontal and near-side crashes, the average age of MAIS 3+ belted front seat occupants injured in crashes less severe than 15 mph is of the order of 50 years. The average age of the population exposed to crashes less severe than 15 mph is under 40 years old. The crash exposure and frequency if injuries to the elderly were both found to be the highest in low severity crashes. The chest is the most frequent body region injured for the elderly. These findings suggest the need for more benign safety systems to protect the elderly in low severity crashes. Design of safety systems for the elderly should give priority to reducing the chest loading in low severity frontal and near-side crashes.

This study quantifies the effect of Vehicle Stability Control (VSC) in reducing crash involvement rates for a subset of vehicles in the US fleet. Crash rates for a variety of impact types before and after VSC technology was implemented are compared. Police-reported crashes from six available US state files from 1998-2002 were analyzed including 13,987 crash-involved study vehicles not equipped with the technology and 5,671 crashes of vehicles equipped with VSC as a standard feature. Overall, an 11.2% (95% CI: 2.4%, 21.1%) reduction in multi-vehicle frontal crash involvement was identified for VSC-equipped vehicles. A 52.6% (95% CI: 42.5%, 62.7%) reduction in single-vehicle crash rates was found.