title: Epidemiology of moderate-to-severe injury patterns observed in rollover crashes.
abstract: BACKGROUND
  Previous epidemiological studies have highlighted the high risk of injury to the head, thorax, and cervical spine in rollover crashes. However, such results provide limited information on whole-body injury distribution and multiple region injury patterns necessary for the improvement and prioritization of rollover-focused injury countermeasures.
  
  
  METHODS
  Sampled cases representing approximately 133,000 U.S. adult occupants involved in rollover crashes (between 1995 and 2013) sustaining moderate-to-severe injuries were selected from the National Automotive Sampling System Crashworthiness Data System database. A retrospective cohort study, based on a survey of population-based data, was used to identify relevant whole body injury patterns.
  
  
  RESULTS
  Among belted occupants injured in rollover crashes, 79.2% sustained injuries to only one body region. The three most frequently injured (AIS2+) body regions were head (42.1%), upper extremity (28.0%), and thorax (27.1%). The most frequent multi-region injury pattern involved the head and upper extremity, but this pattern only accounted for 2.3% of all of occupants with moderate or worse injuries.
  
  
  CONCLUSIONS
  The results indicated that for rollover-dominated crashes, the frequently observed injury patterns involved isolated body regions. In contrast, multi-region injury patterns are more frequently observed in rollovers with significant planar impacts. Identification of region-specific injury patterns in pure rollover crashes is essential for clarifying injury mitigation targets and developing whole-body injury metrics specifically applicable to rollovers.
authors.affiliation: University of Virginia, Department of Public Health Sciences, United States. Electronic address: tmcmurry@virginia.edu.
authors.forename: Timothy L
authors.initials: TL
authors.lastname: McMurry
authors.affiliation: University of Virginia, Center for Applied Biomechanics, United States. Electronic address: dbose@worldbank.org.
authors.forename: Dipan
authors.initials: D
authors.lastname: Bose
authors.affiliation: National Highway Traffic Safety Administration, United States. Electronic address: Stephen.Ridella@dot.gov.
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Ridella
authors.affiliation: Federal Highway Administration, United States. Electronic address: Ana.Eigen@dot.gov.
authors.forename: Ana M
authors.initials: AM
authors.lastname: Eigen
authors.affiliation: University of Virginia, Center for Applied Biomechanics, United States. Electronic address: jrc2h@virginia.edu.
authors.forename: Jeff R
authors.initials: JR
authors.lastname: Crandall
authors.affiliation: University of Virginia, Center for Applied Biomechanics, United States. Electronic address: jrk3z@virginia.edu.
authors.forename: Jason R
authors.initials: JR
authors.lastname: Kerrigan
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae / Q000293:injuries; D006259:Craniocerebral Trauma / Q000453:epidemiology; D016208:Databases, Factual; D005121:Extremities / Q000293:injuries; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000453:epidemiology*; D012189:Retrospective Studies; D013898:Thoracic Injuries / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Body regions; Injury patterns; Rollover