title: Investigation of pulmonary contusion extent and its correlation to crash, occupant, and injury characteristics in motor vehicle crashes.
abstract: BACKGROUND
  Pulmonary contusion (PC) is a leading injury in blunt chest trauma and is most commonly caused by motor vehicle crashes (MVC). To improve understanding of the relationship between insult and outcome, this study relates PC severity to crash, occupant, and injury parameters in MVCs.
  
  
  METHODS
  Twenty-nine subjects with PC were selected from the Crash Injury Research and Engineering Network (CIREN) database, which contains detailed crash and medical information on MVC occupants. Computed tomography scans of these subjects were segmented using a semi-automated protocol to quantify the volumetric percentage of injured tissue in each lung. Techniques were used to quantify the geometry and location of PC, as well as the location of rib fractures. Injury extent including percent PC volume and the number of rib fractures was analyzed and its relation to crash and occupant characteristics was explored.
  
  
  RESULTS
  Frontal and near-side crashes composed 72% of the dataset and the near-side door was the component most often associated with PC causation. The number of rib fractures increased with age and fracture patterns varied with crash type. In near-side crashes, occupant weight and BMI were positively correlated with percent PC volume and the number of rib fractures, and the impact severity was positively correlated with percent PC volume in the lung nearest the impact.
  
  
  CONCLUSIONS
  This study quantified PC morphology in 29 MVC occupants and examined the relationship between injury severity and crash and occupant parameters to better characterize the mechanism of injury. The results of this study may contribute to the prevention, mitigation, and treatment of PC.
authors.affiliation: Virginia Tech-Wake Forest University Center for Injury Biomechanics, Medical Center Blvd., Winston-Salem, NC 27157, USA. asweaver@wakehealth.edu
authors.forename: Ashley A
authors.initials: AA
authors.lastname: Weaver
authors.forename: Kerry A
authors.initials: KA
authors.lastname: Danelson
authors.forename: Elizabeth G
authors.initials: EG
authors.lastname: Armstrong
authors.forename: J Jason
authors.initials: JJ
authors.lastname: Hoth
authors.forename: Joel D
authors.initials: JD
authors.lastname: Stitzel
mesh_terms: D000063:Accidents, Traffic; D000293:Adolescent; D000328:Adult; D000368:Aged; D001334:Automobile Driving; D003288:Contusions / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D055370:Lung Injury / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D012272:Ribs / Q000000981:diagnostic imaging / Q000293:injuries; D012307:Risk Factors; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed