title: Crash test ratings and real-world frontal crash outcomes: a CIREN study.
abstract: OBJECTIVE
  To establish whether the Insurance Institute for Highway Safety (IIHS) offset crash test ratings are linked to different mortality rates in real world frontal crashes.
  
  
  METHODS
  The study used Crash Injury Research Engineering Network drivers of age older than 15 years who were involved in frontal crashes. The Crash Injury Research Engineering Network is a convenience sample of persons injured in crashes with at least one Abbreviated Injury Scale score of 3+ injury or two Abbreviated Injury Scale score of 2+ injuries who were either treated at a Level I trauma center or died. Cases were grouped by IIHS crash test ratings (i.e., good, acceptable, marginal, poor, and not rated). Those rated marginal were excluded because of their small numbers. Mortality rates experienced by these ratings-based groups were compared using the Mantel-Haenszel chi test. Multiple logistic regression models were built to adjust for confounders (i.e., occupant, vehicular, and crash factors).
  
  
  RESULTS
  A total of 1,226 cases were distributed within not rated (59%), poor (12%), average (16%), and good (14%) categories. Those rated good and average experienced a lower unadjusted mortality rate. After adjustment by confounders, those in vehicles rated good experienced a lower risk of death (adjusted OR 0.38 [0.16-0.90]) than those in vehicles rated poor. There was no significant effect for "acceptable" rating. Other factors influencing the occurrence of death were age, DeltaV >or=70 km/h, high body mass index, and lack of restraint use.
  
  
  CONCLUSIONS
  After adjusting for occupant, vehicular, and crash factors, drivers of vehicles rated good by the IIHS experienced a lower risk of death in frontal crashes.
authors.affiliation: Charles C Mathias, Jr National Study Center for Trauma and EMS, University of Maryland, Baltimore, Maryland 21201, USA. gabyryb@pol.net
authors.forename: Gabriel E
authors.initials: GE
authors.lastname: Ryb
authors.forename: Cynthia
authors.initials: C
authors.lastname: Burch
authors.forename: Timothy
authors.initials: T
authors.lastname: Kerns
authors.forename: Patricia C
authors.initials: PC
authors.lastname: Dischinger
authors.forename: Shiu
authors.initials: S
authors.lastname: Ho
mesh_terms: D015998:Abbreviated Injury Scale; D000054:Acceleration; D000063:Accidents, Traffic / Q000401:mortality*; D000328:Adult; D001336:Automobiles / Q000592:standards / Q000706:statistics & numerical data; D001696:Biomechanical Phenomena; D016009:Chi-Square Distribution; D015986:Confounding Factors, Epidemiologic; D003257:Consumer Product Safety / Q000592:standards; D004738:Engineering; D005260:Female; D006801:Humans; D007341:Insurance; D016013:Likelihood Functions; D016015:Logistic Models; D008297:Male; D008348:Manikins; D008875:Middle Aged; D015999:Multivariate Analysis; D011159:Population Surveillance; D011237:Predictive Value of Tests; D018570:Risk Assessment / Q000458:organization & administration*; D014193:Trauma Centers; D014481:United States / Q000453:epidemiology; D014947:Wounds and Injuries / Q000209:etiology / Q000401:mortality