Evaluation of differences in injury patterns according to seat position in trauma victims survived traffic accidents

Daskal, Yaakov; Alfici, Ricardo; Givon, Adi; Peleg, Kobi; Olsha, Oded; Kessel, Boris; Bahouth, Hany; Becker, Alexander; Hadary, Amram; Jeroukhimov, Igor; Karawani, M.; Klein, Yoram; Lin, Guy; Merin, Ofer; Miklosh, B.; Mnouskin, Y.; Rivkind, Avraham I.; Shaked, Gad; Simon, David G.; Sivak, Galit; Soffer, Dror; Stein, M.P.H. Murray B.; Weiss, Mildred

doi:10.1016/j.cjtee.2018.03.001

Cited by 14 publications

(16 citation statements)

References 13 publications

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“…ii) Rear seat passengers were found to be at greater risk for serious traumatic brain injuries (BTIs). 6 This pattern of injuries correlated with TBIs, which was in the current study addressed solely with Glasgow coma scale (GCS) scores. Contrarily, Chieregato et al 7 found a consensus of Italian anesthetists with the classification of TBI severity that includes CT findings and pupil reactivity besides GCS scores.…”

Section: To the Editormentioning

confidence: 83%

Comment on: Patterns of cervical spine injuries in adults at a major trauma center in Saudi Arabia

Albahkley

Mandurah

Alharbi

2021

SMJ

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Section: To the Editormentioning

confidence: 83%

Comment on: Patterns of cervical spine injuries in adults at a major trauma center in Saudi Arabia

Albahkley

Mandurah

Alharbi

2021

SMJ

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“…Safety systems are less effective for passengers than drivers and are optimised to minimise energy transfer from frontal collisions 22 24 25…”

Section: Discussionmentioning

confidence: 99%

Sex-disaggregated analysis of the injury patterns, outcome data and trapped status of major trauma patients injured in motor vehicle collisions: a prespecified analysis of the UK trauma registry (TARN)

et al. 2022

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ObjectivesTo identify the differences between women and men in the probability of entrapment, frequency of injury and outcomes following a motor vehicle collision. Publishing sex-disaggregated data, understanding differential patterns and exploring the reasons for these will assist with ensuring equity of outcomes especially in respect to triage, rescue and treatment of all patients.DesignWe examined data from the Trauma Audit and Research Network (TARN) registry to explore sex differences in entrapment, injuries and outcomes. We explored the relationship between age, sex and trapped status using multivariate logistical regression.SettingTARN is a UK-based trauma registry covering England and Wales.ParticipantsWe examined data for 450 357 patients submitted to TARN during the study period (2012–2019), of which 70 027 met the inclusion criteria. There were 18 175 (26%) female and 51 852 (74%) male patients.Primary and secondary outcome measuresWe report difference in entrapment status, injury and outcome between female and male patients. For trapped patients, we examined the effect of sex and age on death from any cause.ResultsFemale patients were more frequently trapped than male patients (female patients (F) 15.8%, male patients (M) 9.4%; p<0.0001). Trapped male patients more frequently suffered head (M 1318 (27.0%), F 578 (20.1%)), face, (M 46 (0.9%), F 6 (0.2%)), thoracic (M 2721 (55.8%), F 1438 (49.9%)) and limb injuries (M 1744 (35.8%), F 778 (27.0%); all p<0.0001). Female patients had more injuries to the pelvis (F 420 (14.6%), M 475 (9.7%); p<0.0001) and spine (F 359 (12.5%), M 485 (9.9%); p=0.001). Following adjustment for the interaction between age and sex, injury severity score, Glasgow Coma Scale and the Charlson Comorbidity Index, no difference in mortality was found between female and male patients.ConclusionsThere are significant differences between female and male patients in the frequency at which patients are trapped and the injuries these patients sustain. This sex-disaggregated data may help vehicle manufacturers, road safety organisations and emergency services to tailor responses with the aim of equitable outcomes by targeting equal performance of safety measures and reducing excessive risk to one sex or gender.

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“…Especially within the first 5 years of age, children are most likely exposed to road traffic accidents as MVPs [ 2 – 4 , 7 , 14 , 16 , 17 , 27 ]. The discussion about safety regulations for child passengers, such as re-boarding has not been finally resolved for children older than 15 months of age [ 1 , 6 , 8 , 10 ]. Not only the seating position but also the point of accident impact is essential in the development of injury pattern [ 4 , 8 , 10 , 17 ].…”

Section: Discussionmentioning

confidence: 99%

Prevention of severe injuries of child passengers in motor vehicle accidents: is re-boarding sufficient?

Spering

Müller

Füzesi

et al. 2022

Eur J Trauma Emerg Surg

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Purpose The purpose of this study was to evaluate whether prolonged re-boarding of restraint children in motor vehicle accidents is sufficient to prevent severe injury. Methods Data acquisition was performed using the Trauma Register DGU® (TR-DGU) in the time period from 2010 to 2019 of seriously injured children (AIS 2 +) aged 0–5 years as motor vehicle passengers (MVP). Primarily treated and transferred patients where included. Results The study group included 727 of 2030 (35.8%) children, who were severely injured (AIS 2 +) in road traffic accidents, among them 268 (13.2%) as MVPs in the age groups: 0–1 years (42.5%), 2–3 years (26.1%) and 4–5 years (31.3%). The pattern of severe injury was head/brain (56.0%), thoracic (42.2%), abdominal (13.1%), fractures (extremities and pelvis, 52.6%) and spine/severe whiplash (19.8%). The 0–1-year-old MVPs showed the significantly highest proportion of brain injuries with Glasgow Coma Score (GCS) < 8 and severe injury to the spine. The 2–3-year-olds showed the significantly highest proportion of fractures especially the lower extremity and highest proportion of cervical spine injuries of all spine injuries, while the 4–5-year-olds, the significantly highest proportion of abdominal injury and second highest proportion of cervical spine injury of all spine injuries. MVPs of the 0–1-year-old and 2–3-year-old groups showed a higher median Injury Severity Score (ISS) of 21.5 and 22.1 points than the older children (17.0 points). They also suffered an AIS-6-injury significantly more often (9 of 21) of spine (p = 0.001). Especially the cervical spine was significantly more often involved. Passengers at the age of 0–1 years were treated with cardiopulmonary resuscitation (CPR) three times as often as older children in the prehospital setting and twice as often at admission in the Trauma Resuscitation Unit (TRU). Their survival rate was 7 out of 8 (0–1 years), 1 out of 6 (2–3 years) and 1 out of 4 (4–5 years). Conclusion Although the younger MVPs are restraint in a re-boarding position, severe injury to the spine and head occurred more often, while older children as front-faced positioned MVPs suffered from significantly higher rates of abdominal and more often severe facial injury. Our data show, that it is more important to properly restrain children in their adequate car seats (i-size-Norm) and additionally consider the age-related physiological and anatomical specific risks of injury as well as co-factors in road traffic accidents, than only prolonging the re-boarding position over the age of 15 months as a single method.

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Evaluation of differences in injury patterns according to seat position in trauma victims survived traffic accidents

Cited by 14 publications

References 13 publications

Comment on: Patterns of cervical spine injuries in adults at a major trauma center in Saudi Arabia

Comment on: Patterns of cervical spine injuries in adults at a major trauma center in Saudi Arabia

Sex-disaggregated analysis of the injury patterns, outcome data and trapped status of major trauma patients injured in motor vehicle collisions: a prespecified analysis of the UK trauma registry (TARN)

Prevention of severe injuries of child passengers in motor vehicle accidents: is re-boarding sufficient?

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