Identification of vehicle components associated with severe thoracic injury in motor vehicle crashes: a CIREN and NASS analysis.
BACKGROUND
Thoracic trauma secondary to motor vehicle crashes (MVC) continues to be a major cause of morbidity and mortality. Specific vehicle features may increase the risk of severe thoracic injury when striking the occupant. We sought to determine which vehicle contact points were associated with an increased risk of severe thoracic injury in MVC to focus subsequent design modifications necessary to reduce thoracic injury.


METHODS
The National Automotive Sampling System (NASS) databases from 1993 to 2001 and the Crash Injury Research and Engineering Network (CIREN) databases from 1996 to 2004 were analyzed separately using univariate and multivariate logistic regression stratified by restraint use and crash direction. The risk of driver thoracic injury, defined as an abbreviated injury scale (AIS) of score > or =3, was determined as it related to specific points of contact between the vehicle and the driver.


RESULTS
The incidence of severe chest injury in NASS and CIREN were 5.5% and 33%, respectively. The steering wheel, door panel, armrest, and seat were identified as contact points associated with an increased risk of severe chest injury. The door panel and arm rest were consistently a frequent cause of severe injury in both the NASS and CIREN data.


CONCLUSIONS
Several vehicle contact points, including the steering wheel, door panel, armrest and seat are associated with an increased risk of severe thoracic injury when striking the occupant. These elements need to be further investigated to determine which characteristics need to be manipulated in order to reduce thoracic trauma during a crash.
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Division of Trauma/Burns/Critical Care, University of Texas Southwestern Medical Center, Dallas, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA. raminder.nirula@utsouthwestern.edu
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D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000328:Adult; D001336:Automobiles / Q000145:classification; D016208:Databases, Factual; D004867:Equipment Design; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011482:Protective Devices / Q000706:statistics & numerical data; D012307:Risk Factors; D013898:Thoracic Injuries / Q000453:epidemiology*; D015599:Trauma Severity Indices; D014481:United States / Q000453:epidemiology