IntroductionIn the United States, injuries are the leading cause of death during the first four decades of life,' and are responsible for half of all visits to hospital emergency departments.2

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This study measured the incidence of cause-specific trauma in the Cleveland and Lorain-Elyria Standard Metropolitan Statistical Areas (SMSAs), population 2.2 million, as reported to hospital emergency departments (ED). Cases were selected according to a stratified probability sampling plan (N = 9268). The participating hospitals accounted for 97.6 per cent of 903,346 ED

Hospital emergency department visits for motor vehicle trauma occurring in a midwestern metropolitan region (Cleveland and Lorain-Elyria, Ohio Standard Metropolitan Statistical Areas; 2.2 million population) were analyzed to determine the incidence and outcome by age, sex, and road-use category. A 50% incidence sample (n = 20,752) of motor vehicle trauma events to residents of this region was identified from the emergency department records of 41 participating hospitals for a one-year period, 1977. These hospitals accounted for 98% of all emergency department cases in the region. The annual motor vehicle trauma incidence rate per 100,000 population was 1,871. The highest annual incidence rate (4,462) was for ages 20-24; the lowest rates were for infants under one year (837) and for the elderly over 74 years (667). Incidence rate rank-ordered road-use categories were as follows: passenger car occupant, motorized cycle rider, other enclosed vehicle occupant, pedestrian, and pedal cyclist. Above age 4, age-specific male incidence rates significantly exceeded female incidence rates for most road-use categories. There were 80 admissions and 7 fatalities per 1,000 motor vehicle trauma incidence cases. Case-admission ratios were highest for pedestrians (266), riders of motorized cycles (184), and pedal cyclists (115); they were lowest for occupants of partially or fully enclosed vehicles (65). Case-fatality ratios per 1,000 cases were also highest for pedestrians (43) and riders of motorized cycles (11). Male case-fatality ratios exceeded female ratios for each road-use category in nearly all age groups, and male case-admission ratios exceeded those for females ages 10-54. For ages 75 and over, the admission ratios and fatality ratios were nearly twice as high as in any other age group.

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