Railway train versus motor vehicle collisions: a comparative study of injury severity and patterns.
OBJECTIVE
This study compares the demographics, injury severity, resource use, and injury patterns of patients involved in railway train-motor vehicle (RT-MV) to motor vehicle-motor vehicle (MV-MV) collisions.


METHODS
Retrospective trauma registry review of 74 RT-MV and 1,931 MV-MV consecutive patients, age more than 14 years, presenting to two Level I trauma centers, January of 1991 to May of 1998.


RESULTS
Compared with MV-MV, RT-MV had significantly more males (72% vs. 54%), higher mortality (15% vs. 7%), higher Injury Severity Score (median, 20 vs. 9), longer intensive care unit length of stay (1.7 vs. 0.04 days), and longer hospital length of stay (7.5 vs. 4 days). RT-MV patients had a higher percentage of scalp/facial lacerations; intracranial hemorrhage; hemothorax and pneumothorax; fractures of the rib/sternum, upper extremity, skull, and face; and lung, splenic, and renal injuries. After adjusting for the difference in Injury Severity Score between groups, the only remaining significant group difference was the odds of a scalp/facial laceration.


CONCLUSIONS
RT-MV collisions are a marker for more severe injuries, but not a different pattern of injury, compared with MV-MV collisions.
Kligman
M D
MD
St. Vincent Mercy Medical Center, Trauma Program, Toledo, Ohio 43608, USA.
Knotts
F B
FB
Buderer
N M
NM
Kerwin
A J
AJ
Rodgers
J F
JF
D000059:Accidents / Q000401:mortality*; D000063:Accidents, Traffic / Q000401:mortality*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000401:mortality*; D011890:Railroads / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D016019:Survival Analysis; D014481:United States / Q000453:epidemiology