title: The influence of damage distribution on serious brain injury in occupants in frontal motor vehicle crashes.
abstract: In spite of improvements in motor vehicle safety systems and crashworthiness, motor vehicle crashes remain one of the leading causes of brain injury. The purpose of this study was to determine if the damage distribution across the frontal plane affected brain injury severity of occupants in frontal impacts. Occupants in "head on" frontal impacts with a Principal Direction of Force (PDOF) equal to 11, 12, or 1o'clock who sustained serious brain injury were identified using the Crash Injury Research Engineering Network (CIREN) database. Impacts were further classified based on the damage distribution across the frontal plane as distributed, offset, and extreme offset (corner). Overall, there was no significant difference for brain injury severity (based on Glasgow Coma Scale<9, or brain injury AIS>2) comparing occupants in the different impact categories. For occupants in distributed frontal impacts, safety belt use was protective (odds ratio (OR)=0.61) and intrusion at the occupant's seat position was four times more likely to result in severe (Glasgow Coma Scale (GCS)<9) brain injury (OR=4.35). For occupants in offset frontal impacts, again safety belt use was protective against severe brain injury (OR=0.25). Possibly due to the small number of brain-injured occupants in corner impacts, safety belts did not significantly protect against increased brain injury severity during corner impacts. This study supports the importance of safety belt use to decrease brain injury severity for occupants in distributed and offset frontal crashes. It also illustrates how studying "real world" crashes may provide useful information on occupant injuries under impact circumstances not currently covered by crash testing.
authors.affiliation: Department of Surgery, County of San Diego Emergency Medical Services, University of California-San Diego, 6255 Mission Gorge Road, San Diego, CA 92120, USA.
authors.forename: Raul
authors.initials: R
authors.lastname: Coimbra
authors.forename: Carol
authors.initials: C
authors.lastname: Conroy
authors.forename: David B
authors.initials: DB
authors.lastname: Hoyt
authors.forename: Sharon
authors.initials: S
authors.lastname: Pacyna
authors.forename: MarSue
authors.initials: M
authors.lastname: May
authors.forename: Steve
authors.initials: S
authors.lastname: Erwin
authors.forename: Gail
authors.initials: G
authors.lastname: Tominaga
authors.forename: Frank
authors.initials: F
authors.lastname: Kennedy
authors.forename: Michael
authors.initials: M
authors.lastname: Sise
authors.forename: Tom
authors.initials: T
authors.lastname: Velky
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001336:Automobiles / Q000706:statistics & numerical data*; D001930:Brain Injuries / Q000453:epidemiology*; D016208:Databases, Factual; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D015599:Trauma Severity Indices; D014481:United States / Q000453:epidemiology