title: Risk of permanent medical impairment (RPMI) in car crashes correlated to age and gender.
abstract: OBJECTIVE
  As fatalities from car crashes decrease, focus on medical impairment following car crashes becomes more essential. This study assessed the risk of permanent medical impairment based on car occupant injuries. The aim was to study whether the risk of permanent medical impairment differs depending on age and gender.
  
  
  METHODS
  In total, 36,744 injured occupants in car crashes that occurred between 1995 and 2010 were included. All initial injuries (n = 61,440) were classified according to the Abbreviated Injury Scale (AIS) 2005. If a car occupant still had residual symptoms 3 years after a crash, the case was classed as a permanent medical impairment. In total, 5,144 injuries led to permanent medical impairment. The data were divided into different groups according to age and gender as well as levels of permanent impairment. The risk of permanent medical impairment was established for different body regions and injury severity levels, according to the AIS.
  
  
  RESULTS
  The cervical spine was the body region that had the highest number of diagnoses, and occupants who sustained injuries to the upper and lower extremities had the highest risk of medical impairment for both genders. Females aged 60 and above had a higher risk of permanent medical impairment from fractures in the extremities compared to males in the same age group and younger females. Females aged 44 or younger had a higher risk of permanent medical impairment from whiplash-associated disorders (WAD) than males in the same age group. Minor and moderate injuries (AIS 1-2) had a higher risk of permanent medical impairment among older car occupants compared to younger ones.
  
  
  CONCLUSIONS
  Differences in long-term outcome were dependent on both gender and age. Differences between age groups were generally greater than between genders. The vast majority of permanent medical impairments resulted from diagnoses with a low risk of fatality. The results emphasize the impact of age and gender in long-term consequences from car crashes. They could be used when designing safety technology in cars as well as to improve health care by contributing to better allocation of rehabilitation resources following trauma.
authors.affiliation: a Department of Surgical and Perioperative Sciences , Umeå University , Umeå , Sweden.
authors.forename: Markus
authors.initials: M
authors.lastname: Gustafsson
authors.forename: Helena
authors.initials: H
authors.lastname: Stigson
authors.forename: Maria
authors.initials: M
authors.lastname: Krafft
authors.forename: Anders
authors.initials: A
authors.lastname: Kullgren
mesh_terms: D015998:Abbreviated Injury Scale; D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D012306:Risk; D017678:Sex Distribution; D014947:Wounds and Injuries / Q000453:epidemiology*; D055815:Young Adult
keywords: WAD; age; disability; gender; neck injury; permanent medical impairment