title: Estimated injury risk for specific injuries and body regions in frontal motor vehicle crashes.
abstract: OBJECTIVE
  Injury risk curves estimate motor vehicle crash (MVC) occupant injury risk from vehicle, crash, and/or occupant factors. Many vehicles are equipped with event data recorders (EDRs) that collect data including the crash speed and restraint status during a MVC. This study's goal was to use regulation-required data elements for EDRs to compute occupant injury risk for (1) specific injuries and (2) specific body regions in frontal MVCs from weighted NASS-CDS data.
  
  
  METHODS
  Logistic regression analysis of NASS-CDS single-impact frontal MVCs involving front seat occupants with frontal airbag deployment was used to produce 23 risk curves for specific injuries and 17 risk curves for Abbreviated Injury Scale (AIS) 2+ to 5+ body region injuries. Risk curves were produced for the following body regions: head and thorax (AIS 2+, 3+, 4+, 5+), face (AIS 2+), abdomen, spine, upper extremity, and lower extremity (AIS 2+, 3+). Injury risk with 95% confidence intervals was estimated for 15-105 km/h longitudinal delta-Vs and belt status was adjusted for as a covariate.
  
  
  RESULTS
  Overall, belted occupants had lower estimated risks compared to unbelted occupants and the risk of injury increased as longitudinal delta-V increased. Belt status was a significant predictor for 13 specific injuries and all body region injuries with the exception of AIS 2+ and 3+ spine injuries. Specific injuries and body region injuries that occurred more frequently in NASS-CDS also tended to carry higher risks when evaluated at a 56 km/h longitudinal delta-V. In the belted population, injury risks that ranked in the top 33% included 4 upper extremity fractures (ulna, radius, clavicle, carpus/metacarpus), 2 lower extremity fractures (fibula, metatarsal/tarsal), and a knee sprain (2.4-4.6% risk). Unbelted injury risks ranked in the top 33% included 4 lower extremity fractures (femur, fibula, metatarsal/tarsal, patella), 2 head injuries with less than one hour or unspecified prior unconsciousness, and a lung contusion (4.6-9.9% risk). The 6 body region curves with the highest risks were for AIS 2+ lower extremity, upper extremity, thorax, and head injury and AIS 3+ lower extremity and thorax injury (15.9-43.8% risk).
  
  
  CONCLUSIONS
  These injury risk curves can be implemented into advanced automatic crash notification (AACN) algorithms that utilize vehicle EDR measurements to predict occupant injury immediately following a MVC. Through integration with AACN, these injury risk curves can provide emergency medical services (EMS) and other patient care providers with information on suspected occupant injuries to improve injury detection and patient triage.
authors.affiliation: a Virginia Tech-Wake Forest University Center for Injury Biomechanics , Winston-Salem , North Carolina.
authors.forename: Ashley A
authors.initials: AA
authors.lastname: Weaver
authors.forename: Jennifer W
authors.initials: JW
authors.lastname: Talton
authors.forename: Ryan T
authors.initials: RT
authors.lastname: Barnard
authors.forename: Samantha L
authors.initials: SL
authors.lastname: Schoell
authors.forename: Katrina R
authors.initials: KR
authors.lastname: Swett
authors.forename: Joel D
authors.initials: JD
authors.lastname: Stitzel
mesh_terms: D015998:Abbreviated Injury Scale; D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D018570:Risk Assessment; D012622:Seat Belts / Q000706:statistics & numerical data; D014947:Wounds and Injuries / Q000209:etiology*
keywords: Abbreviated Injury Scale; advanced automatic crash notification; event data recorder; injury risk curve; logistic regression