title: BMI and risk of serious upper body injury following motor vehicle crashes: concordance of real-world and computer-simulated observations.
abstract: BACKGROUND
  Men tend to have more upper body mass and fat than women, a physical characteristic that may predispose them to severe motor vehicle crash (MVC) injuries, particularly in certain body regions. This study examined MVC-related regional body injury and its association with the presence of driver obesity using both real-world data and computer crash simulation.
  
  
  RESULTS
  Real-world data were from the 2001 to 2005 National Automotive Sampling System Crashworthiness Data System. A total of 10,941 drivers who were aged 18 years or older involved in frontal collision crashes were eligible for the study. Sex-specific logistic regression models were developed to analyze the associations between MVC injury and the presence of driver obesity. In order to confirm the findings from real-world data, computer models of obese subjects were constructed and crash simulations were performed. According to real-world data, obese men had a substantially higher risk of injury, especially serious injury, to the upper body regions including head, face, thorax, and spine than normal weight men (all p<0.05). A U-shaped relation was found between body mass index (BMI) and serious injury in the abdominal region for both men and women (p<0.05 for both BMI and BMI(2)). In the high-BMI range, men were more likely to be seriously injured than were women for all body regions except the extremities and abdominal region (all p<0.05 for interaction between BMI and sex). The findings from the computer simulation were generally consistent with the real-world results in the present study.
  
  
  CONCLUSIONS
  Obese men endured a much higher risk of injury to upper body regions during MVCs. This higher risk may be attributed to differences in body shape, fat distribution, and center of gravity between obese and normal-weight subjects, and between men and women. Please see later in the article for the Editors' Summary.
authors.affiliation: Injury Research Center, Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America.
authors.forename: Shankuan
authors.initials: S
authors.lastname: Zhu
authors.forename: Jong-Eun
authors.initials: JE
authors.lastname: Kim
authors.forename: Xiaoguang
authors.initials: X
authors.lastname: Ma
authors.forename: Alan
authors.initials: A
authors.lastname: Shih
authors.forename: Purushottam W
authors.initials: PW
authors.lastname: Laud
authors.forename: Frank
authors.initials: F
authors.lastname: Pintar
authors.forename: Wei
authors.initials: W
authors.lastname: Shen
authors.forename: Steven B
authors.initials: SB
authors.lastname: Heymsfield
authors.forename: David B
authors.initials: DB
authors.lastname: Allison
mesh_terms: D000063:Accidents, Traffic; D015992:Body Mass Index; D003198:Computer Simulation; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D018986:Motor Vehicles; D009765:Obesity / Q000150:complications; D016017:Odds Ratio; D012307:Risk Factors; D012727:Sex Characteristics; D014947:Wounds and Injuries / Q000150:complications / Q000473:pathology*