title: Crash test rating and likelihood of major thoracoabdominal injury in motor vehicle crashes: the new car assessment program side-impact crash test, 1998-2010.
abstract: BACKGROUND
  The National Highway Traffic Safety Administration's New Car Assessment Program (NCAP) implemented side-impact crash testing on all new vehicles since 1998 to assess the likelihood of major thoracoabdominal injuries during a side-impact crash. Higher crash test rating is intended to indicate a safer car, but the real-world applicability of these ratings is unknown. Our objective was to determine the relationship between a vehicle's NCAP side-impact crash test rating and the risk of major thoracoabdominal injury among the vehicle's occupants in real-world side-impact motor vehicle crashes.
  
  
  METHODS
  The National Automotive Sampling System Crashworthiness Data System contains detailed crash and injury data in a sample of major crashes in the United States. For model years 1998 to 2010 and crash years 1999 to 2010, 68,124 occupants were identified in the Crashworthiness Data System database. Because 47% of cases were missing crash severity (ΔV), multiple imputation was used to estimate the missing values. The primary predictor of interest was the occupant vehicle's NCAP side-impact crash test rating, and the outcome of interest was the presence of major (Abbreviated Injury Scale [AIS] score ≥ 3) thoracoabdominal injury.
  
  
  RESULTS
  In multivariate analysis, increasing NCAP crash test rating was associated with lower likelihood of major thoracoabdominal injury at high (odds ratio [OR], 0.8; 95% confidence interval [CI], 0.7-0.9; p < 0.01) and medium (OR, 0.9; 95% CI, 0.8-1.0; p < 0.05) crash severity (ΔV), but not at low ΔV (OR, 0.95; 95% CI, 0.8-1.2; p = 0.55). In our model, older age and absence of seat belt use were associated with greater likelihood of major thoracoabdominal injury at low and medium ΔV (p < 0.001), but not at high ΔV (p ≥ 0.09).
  
  
  CONCLUSIONS
  Among adults in model year 1998 to 2010 vehicles involved in medium and high severity motor vehicle crashes, a higher NCAP side-impact crash test rating is associated with a lower likelihood of major thoracoabdominal trauma.
  
  
  METHODS
  Epidemiologic study, level III.
authors.affiliation: From the University of Washington Departments of Urology (B.F., H.W., B.V.) and Surgery (R.K., E.B.), University of Washington, Harborview Injury Prevention and Research Center, Harborview Medical Center; Group Health Research Institute (C.D.M.), Seattle, Washington; Scott Department of Urology (T.G.S.), Baylor College of Medicine, Ben Taub General Hospital, Houston, Texas.
authors.forename: Bradley D
authors.initials: BD
authors.lastname: Figler
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Mack
authors.forename: Robert
authors.initials: R
authors.lastname: Kaufman
authors.forename: Hunter
authors.initials: H
authors.lastname: Wessells
authors.forename: Eileen
authors.initials: E
authors.lastname: Bulger
authors.forename: Thomas G
authors.initials: TG
authors.lastname: Smith
authors.forename: Bryan
authors.initials: B
authors.lastname: Voelzke
mesh_terms: D015998:Abbreviated Injury Scale; D000007:Abdominal Injuries / Q000453:epidemiology* / Q000517:prevention & control; D000063:Accidents, Traffic / Q000706:statistics & numerical data; D000328:Adult; D001336:Automobiles / Q000592:standards*; D005260:Female; D006077:Government Agencies; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D013898:Thoracic Injuries / Q000453:epidemiology* / Q000517:prevention & control; D014481:United States / Q000453:epidemiology