Use of a structural deformity index as a predictor of severity among trauma victims in motor vehicle crashes.
BACKGROUND
Information obtained from vehicle crash scenes, called kinematics, may prove useful in the management of victims and may complement anatomical and physiological findings.


OBJECTIVE
In addition to analyzing the significance of age, gender, position occupied in the vehicle, the use of restraint systems, and ejection from the vehicle, the objective was to carry out a preliminary study of what we have defined as the Structural Deformity Index (SDI) to verify its usefulness in predicting injury severity at the scene of a motor vehicle crash. The index consists of various parameters that can be easily identified at the crash scene.


METHODS
An historical cohort of vehicle occupants involved in crashes in the Navarra province of Spain from January 1, 2001 to December 31, 2002 was studied. Information was collected from the database of the Navarra Severe Trauma Victim group study. Bivariate statistical analysis and multivariate logistic regression models were employed for statistical management.


RESULTS
There were 212 vehicle occupants identified. Significant differences in severity of injury, and of mortality, were observed based on age, ejection from the vehicle, and a high SDI. Logistic regression showed significant differences in injury severity by age (odds ratio [OR] 6.55, 95% confidence interval [CI] 1.6-26.7) and high SDI (OR 1.84, 95% CI 1-3.3), as well as differences in the patient death rate by age (OR 6.92, 95% CI 1.2-38.9) and high SDI (OR 3.28, 95% CI 1.5-6.8).


CONCLUSIONS
The SDI is useful to the first responders, enabling them to alert and transmit objective, reliable information to the emergency coordination center, thus efficiently activating health care resources. In addition, use of the SDI may assist prehospital and hospital health care providers to suspect the presence of particular serious injuries when anatomical and physiological criteria are not definitive.
Reyero Díez
Diego
D
Prehospital Emergency, Navarra Health Services, Pamplona, Spain.
Otano
Tomás Belzunegui
TB
Bermejo Fraile
Begoña
B
Louis
Clint Jean
CJ
Ramírez
Jose Roldán
JR
Sucunza
Alfredo Echarri
AE
D000063:Accidents, Traffic; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001696:Biomechanical Phenomena; D002648:Child; D002675:Child, Preschool; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D015599:Trauma Severity Indices; D014947:Wounds and Injuries / Q000145:classification*; D055815:Young Adult