title: Demographics, Velocity Distributions, and Impact Type as Predictors of AIS 4+ Head Injuries in Motor Vehicle Crashes.
abstract: The objective of the study was to determine differences between the United States-based NASS and CIREN and Australia-based ANCIS databases in occupant-, crash-, and vehicle-related parameters for AIS 4+ head injuries in motor vehicle crashes. Logistic regression analysis was performed to examine roles of the change in velocity (DV), crash type (frontal, far-side, nearside, rear impact), seatbelt use, and occupant position, gender, age, stature, and body mass in cranial traumas. Belted and unbelted non-ejected occupant (age >16 years) data from 1997-2006 were used for the NASS and CIREN datasets, and 2000-2010 for ANCIS. Vehicle model year, and occupant position and demographics including body mass index (BMI) data were obtained. Injuries were coded using AIS 1990-1998 update. Similarities were apparent across all databases: mean demographics were close to the mid-size anthropometry, mean BMI was in the normal to overweight range, and representations of extreme variations were uncommon. Side impacts contributed to over one-half of the ensemble, implying susceptibility to head trauma in this mode. Odds of sustaining head injury increased by 4% per unit increase in DV (OR: 1.04, 95% CI: 1.03-1.04, p<0.001; adjusted for other variables); one-half for belted compared to unbelted occupants (OR: 0.48, 95% CI: 0.37-0.61, p<0.001); nearside, then far-side had significantly higher odds than frontal, and no difference by gender or position (front-left, front-right). Similar crash- and occupant-related outcomes from the two continents indicate a worldwide need to revise the translation acceleration-based head injury criterion to include the angular component in an appropriate format for improved injury assessment and mitigation.
authors: Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA Accident Research Centre, Monash University, Melbourne, Australia Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA Accident Research Centre, Monash University, Prato, Italy.
authors: Narayan
authors: N
authors: Yoganandan
authors: Michael
authors: M
authors: Fitzharris
authors: Frank A
authors: FA
authors: Pintar
authors: Brian D
authors: BD
authors: Stemper
authors: James
authors: J
authors: Rinaldi
authors: Dennis J
authors: DJ
authors: Maiman
authors: Brian N
authors: BN
authors: Fildes
mesh_terms: D000063:Accidents, Traffic; D006259:Craniocerebral Trauma; D003710:Demography; D006801:Humans; D018986:Motor Vehicles; D012622:Seat Belts; D014481:United States; D014947:Wounds and Injuries