title: Thoracic injuries sustained by severely injured front-seat passengers and drivers: injury patterns and their relationship to crash characteristics.
abstract: Thoracic injuries are common in vehicle crashes, but only a few studies thus far have analysed the relationship between injury characteristics and collision details and discussed the possible implications for future vehicle design and prevention. In this study, the crash details were prospectively collected at the scene of injury between 2004 and 2009 for severely injured patients. The collected data included the type of collision, angle of impact and change of velocity on impact as well as injury characteristics and patient demographics, including abbreviated injury scale (AIS) and injury severity score (ISS).There were 5998 accidents involving 8830 patients over this five-year period; 31 met the inclusion criteria (23 males and eight females). The mean ISS was 37 ± 12.68, the mean AIS Thorax was 4.0. Lung contusions were found in 90% of the patients, pneumothoraces in 58% and rib fractures in 81%. There was a significant relationship between accident deceleration speed (ΔV), AIS Thorax (p = 0.02) and the incidence of pneumothoraces (p = 0.046). The analysis showed a high overall incidence of thoracic injuries in car passengers. Future improvements in automobile safety and design should seek to reduce the incidence of thoracic injuries by uniform vehicle deformation and further implementation of side airbags.
authors.affiliation: a Trauma Department , Medical School Hannover , Carl-Neuberg-Str. 1 , Hannover , 30625 , Germany.
authors.forename: Timo
authors.initials: T
authors.lastname: Stübig
authors.forename: Stephan
authors.initials: S
authors.lastname: Brand
authors.forename: Christian
authors.initials: C
authors.lastname: Zeckey
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Beltran
authors.forename: Dietmar
authors.initials: D
authors.lastname: Otte
authors.forename: Christian
authors.initials: C
authors.lastname: Krettek
authors.forename: Carl
authors.initials: C
authors.lastname: Haasper
mesh_terms: D015998:Abbreviated Injury Scale; D000063:Accidents, Traffic; D000328:Adult; D001336:Automobiles; D003654:Deceleration / Q000009:adverse effects*; D005260:Female; D005858:Germany; D006801:Humans; D015601:Injury Severity Score; D055370:Lung Injury / Q000000981:diagnostic imaging / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011030:Pneumothorax / Q000000981:diagnostic imaging / Q000209:etiology*; D011446:Prospective Studies; D011859:Radiography; D012253:Rib Fractures / Q000000981:diagnostic imaging / Q000209:etiology*; D055815:Young Adult