title: Differences in long-term medical consequences depending on impact direction involving passenger cars.
abstract: OBJECTIVE
  There is limited knowledge of the long-term medical consequences for occupants injured in car crashes in various impact directions. Thus, the objective was to evaluate whether injuries leading to permanent medical impairment differ depending on impact direction.
  
  
  METHODS
  In total, 36,743 injured occupants in car crashes that occurred between 1995 and 2011 were included. All initial injuries (n = 61,440) were classified according to the Abbreviated Injury Scale (AIS) 2005. Injured car occupants were followed for at least 3 years to assess permanent medical impairment. The data were divided into different groups according to impact direction and levels of permanent impairment. The risk of permanent medical impairment was established for different body regions and injury severity levels, according to AIS.
  
  
  RESULTS
  It was found that almost 12% of all car occupants sustained a permanent medical impairment. Given an injury, car occupants involved in rollover crashes had the highest overall risk to sustain a permanent medical impairment. Half of the head injuries leading to long-term consequences occurred in frontal impacts. Far-side occupants had almost the same risk as near-side occupants. Occupants who sustained a permanent medical impairment from cervical spine injuries had similar risk in all impact directions (13%) except from rollover (17%). However, these injuries occurred more often in rear crashes. Most of the injuries leading to long-term consequences were classified as minor injuries by AIS for all impact directions.
  
  
  CONCLUSIONS
  Studying crash data from a perspective of medical impairment is important to identify injuries that might not be prioritized only considering the AIS but might lead to lower quality of life for the occupant and also costs for society. These results can be used for road transport system strategies and for making priority decisions in vehicle design.
authors.affiliation: a Folksam Research , Stockholm , Sweden.
authors.forename: Helena
authors.initials: H
authors.lastname: Stigson
authors.forename: Markus
authors.initials: M
authors.lastname: Gustafsson
authors.forename: Cecilia
authors.initials: C
authors.lastname: Sunnevång
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; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008134:Long-Term Care / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D012306:Risk; D014947:Wounds and Injuries / Q000209:etiology* / Q000628:therapy*; D055815:Young Adult
keywords: front impact; impairment; injury outcome; rear impact; rollover; side impact