title: Delta V as a predictor of significant injury for children involved in frontal motor vehicle crashes.
abstract: OBJECTIVE
  The objective of this study was to examine the association between delta V and risk of injury to children involved in frontal motor vehicle crashes.
  
  
  BACKGROUND
  Previous studies, primarily focused on adult occupants, have demonstrated the relationship between crash severity, as measured by delta V and injury severity. As children have unique safety needs, these results cannot be directly applied to the pediatric population.
  
  
  METHODS
  Case series crash investigation data and clinical injury information were reviewed from a child-focused crash surveillance system. Analyses were performed examining the relationship between the estimated delta V and any AIS > or = 2 or any AIS > or = 3 injury.
  
  
  RESULTS
  Detailed crash investigation and clinical data were available on 407 children involved in 235 frontal crashes. The average delta V for all crashes was 29 +/- 16.9 kph [18 +/- 10.5 mph (range, 5-123 kph)]. Delta V was strongly and positively associated with the odds of both an AIS > or = 2 and AIS > or = 3 injury (P < 0.0001). The adjusted odds of at least one AIS > or = 2 injury increased on average by 56% (95% confidence interval [CI], 33%-85%) for each 10 kph increase in delta V. Similarly, the adjusted odds of at least one AIS > or = 3 injury increased on average by 67% (95% CI, 40%-102%) for each 10 kph increase in delta V. The delta V at which 50% of child occupants would be expected to sustain any AIS > or = 2 injury was 37 kph [23.0 mph (95% CI, 32-45 kph)], and any AIS > or = 3 injury was 63 kph [39.1 mph (95% CI, 51-infinity kph)].
  
  
  CONCLUSIONS
  Delta V is strongly predictive of injury risk for child occupants. As many newer generation cars are now fitted with event data recorders, this information is increasingly available and may become useful as a clinical predictor.
authors.affiliation: Surgery, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA. nance@email.chop.edu
authors.forename: Michael L
authors.initials: ML
authors.lastname: Nance
authors.forename: Michael R
authors.initials: MR
authors.lastname: Elliott
authors.forename: Kristy B
authors.initials: KB
authors.lastname: Arbogast
authors.forename: Flaura K
authors.initials: FK
authors.lastname: Winston
authors.forename: Dennis R
authors.initials: DR
authors.lastname: Durbin
mesh_terms: D015998:Abbreviated Injury Scale; D000063:Accidents, Traffic; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008962:Models, Theoretical; D009038:Motion; D011237:Predictive Value of Tests; D014947:Wounds and Injuries