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Risk factors affecting severe thoracic injuries in motor vehicle collisions based on age group and collision directions

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Objective

This study aimed to investigate the effect of age and collision direction on the severity of thoracic injuries based on a real-world crash database.

Methods

This was a retrospective, observational study. We used the Korean In-Depth Accident Study (KIDAS) database, which was collected from crash injury patients who visited emergency medical centers between January 2011 and February 2022 in Korea. Among the 4520 patients enrolled in the database, we selected 1908 adult patients with abbreviated injury scale (AIS) scores between 0 and 6 in the thoracic region. We classified patients with an AIS score of 3 or higher into the severe injury group.

Results

The incidence rate of severe thoracic injuries due to motor vehicle accidents was 16.4%. Between the severe and non-severe thoracic injury groups, there were significant differences in sex, age, collision direction, crash object, seatbelt use, and delta-V parameters. Among the age groups, over 55 years occupants had a higher risk in the thoracic regions than those under 54 years occupants. The risk of severe thoracic injury was highest in near-side collisions in all collision directions. Far-side and rear-end collisions showed a lower risk than frontal collisions. Occupants with unfastened seatbelts were at greater risk.

Conclusions

The risk of severe thoracic injury is high in near-side collisions among elderly occupants. However, the risk of injury for elderly occupants increases in a super-aging society. To reduce thoracic injury, safety features made for elderly occupants in near-side collisions are required.

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References

  1. CDC. WISQARS (Web‐based Injury Statistics Query and Reporting System). Injury Center. 2020.

  2. Schoell SL, Weaver AA, Talton JW, Barnard RT, Baker G, Stitzel JD, Zonfrillo MR. Functional outcomes of motor vehicle crash thoracic injuries in pediatric and adult occupants. Traffic Inj Prev. 2018;19(3):280–6.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Mbarga NF, Abubakari AR, Aminde LN, Morgan AR. Seatbelt use and risk of major injuries sustained by vehicle occupants during motor-vehicle crashes: a systematic review and meta-analysis of cohort studies. BMC Public Health. 2018;18(1):1–11.

    Google Scholar 

  4. Chiumello D, Coppola S, Froio S, Gregoretti C, Consonni D. Noninvasive ventilation in chest trauma: systematic review and meta-analysis. Intensive Care Med. 2013;39:1171–80.

    Article  CAS  PubMed  Google Scholar 

  5. Stitzel JD, Kilgo PD, Weaver AA, Martin RS, Loftis KL, Meredith JW. Age thresholds for increased mortality of predominant crash induced thoracic injuries. Ann Adv Automot Med. 2010;54:41–50.

    PubMed  PubMed Central  Google Scholar 

  6. Beklemysheva KA, Danilov AA, Petrov IB, Salamatova VY, Vassilevski YV, Vasyukov AV. Virtual blunt injury of human thorax: Age-dependent response of vascular system. Russ J Numer Anal Math Model. 2015;30(5):259–68.

    Article  Google Scholar 

  7. Agnew AM, Kang YS, Moorhouse K, Herriot R, Bolte JH IV. Age-related changes in stiffness in human ribs. In: 2013 IRCOBI Conference Proceedings—International Research Council on the Biomechanics of Injury. 2013; 257–269.

  8. Weaver AA, Schoell SL, Stitzel JD. Morphometric analysis of variation in the ribs with age and sex. J Anat. 2014;225(2):246–61. https://doi.org/10.1111/joa.12203.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Qin X, Wang K, Cutler CE. Analysis of crash severity based on vehicle damage and occupant injuries. Transp Res Rec. 2013;2386(1):95–102.

    Article  Google Scholar 

  10. Morgan RM, CuiC, Digges KH, Cao L, Kan CD. Impact and injury patterns in between-rails frontal crashes of vehicles with good ratings for frontal crash protection. Ann Adv Automot Med. 2012; 56:255–265.

  11. El-Menyar A, Latifi R, AbdulRahman H, Zarour A, Tuma M, Parchani A, Peralta R, Al TH. Age and traumatic chest injury: a 3-year observational study. Eur J Trauma Emerg Surg. 2013;39:397–403.

    Article  CAS  PubMed  Google Scholar 

  12. Arbogast KB, Locey CM, Zonfrillo MR. Differences in thoracic injury causation patterns between seat belt restrained children and adults. Ann Adv Automot Med. 2012;56:213–21 (PMID: 23169131).

    PubMed  PubMed Central  Google Scholar 

  13. Huber S, Biberthaler P, Delhey P, Trentzsch H, Winter H, van Griensven M, Lefering R, Huber-Wagner S, Trauma Register DGU. Predictors of poor outcomes after significant chest trauma in multiply injured patients: a retrospective analysis from the German Trauma Registry (Trauma Register DGU(R)). Scand J Trauma Resusc Emerg Med. 2014;22:52. https://doi.org/10.1186/s13049-014-0052-4.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Nishimoto T, Mukaigawa K, Tominaga S, Lubbe N, Kiuchi T, Motomura T, Matsumoto H. Serious injury prediction algorithm based on large-scale data and under-triage control. Accid Anal Prev. 2017;98:266–76. https://doi.org/10.1016/j.aap.2016.09.028.

    Article  PubMed  Google Scholar 

  15. Weir CB, Jan A. BMI classification percentile and cut off points. Treasure Island: StatPearls Publishing; 2021.

    Google Scholar 

  16. Bareiss M, Gabler HC. Estimating near side crash injury risk in best performing passenger vehicles in the United States. Accid Anal Prev. 2020;138: 105434.

    Article  PubMed  Google Scholar 

  17. Augenstein J, Perdeck E, Stratton J, Digges K, Bahouth G. Characteristics of crashes that increase the risk of serious injuries. Annu Proc Assoc Adv Automot Med. 47:561–576.

  18. Cormier JM. The influence of body mass index on thoracic injuries in frontal impacts. Accid Anal Prev. 2003; 40(2):610–615.

  19. Ernstberger A, Joeris A, Daigl M, Kiss M, Angerpointner K, Nerlich M, Schmucker U. Decrease of morbidity in road traffic accidents in a high income country–an analysis of 24,405 accidents in a 21 year period. Injury. 2015;46:S135–43.

    Article  PubMed  Google Scholar 

  20. Griffin R, Huisingh C, McGwin G Jr, Reiff D. Association between side-impact airbag deployment and risk of injury: a matched cohort study using the CIREN and the NASS-CDS. J Trauma Acute Care Surg. 2012;73(4):914–8.

    Article  PubMed  Google Scholar 

  21. Moon S, Ranchet M, Akinwuntan AE, Tant M, Carr DB, Raji MA, Devos H. The impact of advanced age on driving safety in older adults with medical conditions. Gerontology. 2018;64(3):291–9. https://doi.org/10.1159/000486511.

    Article  PubMed  Google Scholar 

  22. Agnew AM, Schafman M, Moorhouse K, White SE, Kang YS. The effect of age on the structural properties of human ribs. J Mech Behav Biomed Mater. 2015;41:302–14.

    Article  PubMed  Google Scholar 

  23. Prochowski L, Ziubiński M, Dziewiecki K, Szwajkowski P. Impact energy and the risk of injury to motorcar occupants in the front-to side vehicle collision. Nonlinear Dyn. 2022;110:3333–54. https://doi.org/10.1007/s11071-022-07779-8.

    Article  Google Scholar 

  24. Ryb GE, Dischinger PC. Crash-related mortality and model year: are newer vehicles safer? Ann Adv Automot Med. 2011;55:113–21.

    PubMed  PubMed Central  Google Scholar 

  25. Brumbelow ML. Front crash injury risks for restrained drivers in good-rated vehicles by age, impact configuration, and EDR-based delta V. In Proceedings of IRCOBI Conference. 2019.

  26. Nirula R, Pintar FA. Identification of vehicle components associated with severe thoracic injury in motor vehicle crashes: a CIREN and NASS analysis. Accid Anal Prev. 2008;40(1):137–41.

    Article  CAS  PubMed  Google Scholar 

  27. Viano DC, Parenteau CS. Severe injury to near- and far-seated occupants in side impacts by crash severity and belt use. Traffic Inj Prev. 2010;11(1):69–78. https://doi.org/10.1080/15389580903479178.

    Article  PubMed  Google Scholar 

  28. Yoshida S, Hasegawa T, Tominaga S, Nishimoto T. Development of injury prediction models for advanced automatic collision notification based on Japanese accident data. Int J Crashworthiness. 2016;21(2):112–9.

    Article  Google Scholar 

  29. Santamariña-Rubio E, Pérez K, Olabarria M, Novoa AM. Gender differences in road traffic injury rate using time travelled as a measure of exposure. Accid Anal Prev. 2014;65:1–7.

    Article  PubMed  Google Scholar 

  30. Forman J, Poplin GS, Shaw CG, McMurry TL, Schmidt K, Ash J, Sunnevang C. Automobile injury trends in the contemporary fleet: Belted occupants in frontal collisions. Traffic Inj Prev. 2019;20(6):607–12.

    Article  PubMed  Google Scholar 

  31. Amarasingha N, Dissanayake S. Gender differences of young drivers on injury severity outcome of highway crashes. J Safety Res. 2014;49:113–20. https://doi.org/10.1016/j.jsr.2014.03.004.

    Article  PubMed  Google Scholar 

  32. Ryb GE, Dischinger PC, Kufera JA, Burch CA. Delta V, principal direction of force, and restraint use contributions to motor vehicle crash mortality. J Trauma. 2007;63(5):1000–5. https://doi.org/10.1097/TA.0b013e31815885c8.

    Article  PubMed  Google Scholar 

  33. Turkovich M, Hu JW, van Roosmalen L, Brienza D. Computer simulations of obesity effects on occupant injury in frontal impacts. Int J Crashworthiness. 2013;18(5):502–15.

    Article  Google Scholar 

  34. Breen JM, Næss PA, Gaarder C, Stray-Pedersen A. Autopsy findings in drivers and passengers from fatal motor vehicle collisions: limited differences in injury patterns and toxicological test results. Forensic Sci Med Pathol. 2021;17(2):235–46. https://doi.org/10.1007/s12024-021-00359-z.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Hawas YE, Alam MD. Evaluation of seatbelt and airbag effectiveness in reducing severe and fatal injuries in the UAE. J Traffic Logist Eng. 2015;3(2):87–93.

    Article  Google Scholar 

  36. Toy EL, Hammitt JK. Safety impacts of SUVs, vans, and pickup trucks in two-vehicle crashes. Risk Anal. 2003;23(4):641–50.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

This research was supported by the National Research Foundation of Korea (NRF) Grant funded by the Korean government (MSIT) (no.2021R1A2C2094669).

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Authors and Affiliations

  1. Center for Automotive Medical Science Institute, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, 20 Ilsan‑ro, Wonju, Gangwon‑do, 26426, South Korea

    Dooruh Choi, Kang Hyun Lee, Oh Hyun Kim, Joon Seok Kong, Chan Young Kang & Yeon Il Choo

  2. Department of Emergency Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, 20 Ilsan‑ro, Wonju, Gangwon‑do, 26426, South Korea

    Dooruh Choi, Kang Hyun Lee, Oh Hyun Kim, Joon Seok Kong, Chan Young Kang & Yeon Il Choo

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  1. Dooruh Choi
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Correspondence to Kang Hyun Lee.

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The authors declare that there are no competing interests.

Ethical approval

This study was reviewed and approved by the Institutional Review Board for Human Research at Yonsei University Wonju Severance Christian Hospital (CR317137-006).

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Choi, D., Lee, K.H., Kim, O.H. et al. Risk factors affecting severe thoracic injuries in motor vehicle collisions based on age group and collision directions. Eur J Trauma Emerg Surg 49, 2429–2437 (2023). https://doi.org/10.1007/s00068-023-02297-7

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  • DOI: https://doi.org/10.1007/s00068-023-02297-7

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