title: Crash characteristics and injury patterns of restrained front seat occupants in far-side impacts.
abstract: OBJECTIVE
  The study was conducted to determine the association between vehicle-, crash-, and demographic-related factors and injuries to front seat far-side occupants in modern environments.
  
  
  METHODS
  Field data were obtained from the NASS-CDS database for the years 2009-2012. Inclusion factors included the following: adult restrained front outboard-seated occupants, no ejection or rollovers, and vehicle model years less than 10 years old at the time of crash. Far-side crashes were determined by using collision deformation classification. Injuries were scored using the Abbreviated Injury Scale (AIS). Injuries (MAIS 2+, MAIS 3+, M denotes maximum score) were examined based on demographics, change in velocity, vehicle type, direction of force, extent zone, collision partner, and presence of another occupant in the front seat. Only weighted data were used in the analysis. Injuries to the head and face, thorax, abdomen, pelvis, and upper and lower extremity regions were studied. Odds ratios and upper and lower confidence intervals were estimated from multivariate analysis.
  
  
  RESULTS
  Out of 519,195 far-side occupants, 17,715 were MAIS 2+ and 4,387 were MAIS 3+ level injured occupants. The mean age, stature, total body mass, and body mass index (BMI) were 40.7 years, 1.7 m, 77.2 kg, and 26.8 kg/m2, respectively. Of occupants with MAIS 2+ injuries, 51% had head and 19% had thorax injuries. Of occupants with MAIS 3+ injuries, 50% had head and 69% had thorax injuries. The cumulative distribution of changes in velocities at the 50th percentile for the struck vehicle for all occupants and occupants with MAIS 2+ and MAIS 3+ injuries were 19, 34, and 42 km/h, respectively. Furthermore, 73% of MAIS 2+ injuries and 86% of MAIS 3+ injuries occurred at a change in velocity of 24 km/h or greater. Odds of sustaining MAIS 2+ and MAIS 3+ injuries increased with each unit increase in change in velocity, stature, and age, with one exception. Odds of sustaining injuries were higher with the presence of an occupant in the front seat at the MAIS 3+ level, although it was reversed at the lower level. The extent zone of 3+ increased the odds compared to the extent zones of 1 to 2 at both MAIS 2+ and MAIS 3+ injuries. Odds ratios and confidence intervals are given.
  
  
  CONCLUSIONS
  The findings are as follows: head and thorax are the more frequently injured body regions, and the prevalence of cranium injuries is similar at both injury severities; thoracic injuries are more prevalent at the MAIS 3+ level; the presence of another front seat occupant plays a role in MAIS 3+ trauma; injuries continue to occur at changes in velocity representative of side impact environments; and mean demographic factors are close to mid-size automotive anthropometry, indicating the need to pursue this line of study. Because data were gathered from only 4 years, it would be important to include additional NASS-CDS database years, rescore injuries from previous years, and analyze other international databases to reinforce these findings for advancing safety for far-side occupants.
authors.affiliation: a Department of Neurosurgery , Medical College of Wisconsin , Milwaukee , Wisconsin.
authors.forename: Narayan
authors.initials: N
authors.lastname: Yoganandan
authors.forename: Mike W J
authors.initials: MW
authors.lastname: Arun
authors.forename: Dale E
authors.initials: DE
authors.lastname: Halloway
authors.forename: Frank A
authors.initials: FA
authors.lastname: Pintar
authors.forename: Dennis J
authors.initials: DJ
authors.lastname: Maiman
authors.forename: Aniko
authors.initials: A
authors.lastname: Szabo
authors.forename: Rodney W
authors.initials: RW
authors.lastname: Rudd
mesh_terms: D015998:Abbreviated Injury Scale; D000054:Acceleration / Q000009:adverse effects; D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000328:Adult; D001334:Automobile Driving / Q000706:statistics & numerical data*; D001827:Body Height; D015992:Body Mass Index; D006259:Craniocerebral Trauma / Q000453:epidemiology / Q000209:etiology; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D012622:Seat Belts / Q000706:statistics & numerical data*; D013898:Thoracic Injuries / Q000453:epidemiology / Q000209:etiology; D014947:Wounds and Injuries / Q000453:epidemiology / Q000209:etiology*
keywords: NASS-CDS; change in velocity; far-side crashes; motor vehicle injuries; restrained occupant