Occupant injuries in light passenger vehicles—A NASS study to enable priorities for development of injury prediction capabilities of human body models

Pipkorn, Bengt; Iraeus, Johan; Lindkvist, Mats; Puthan, Pradeep; Bunketorp, Olle

doi:10.1016/j.aap.2020.105443

Cited by 18 publications

(17 citation statements)

References 10 publications

(13 reference statements)

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Section: Introductionmentioning

confidence: 99%

“…Rib fractures are the most commonly occurring thoracic injury, and their presence acts as a sentinel for further injury to critical organs in the chest and abdomen (Dogrul et al, 2020; Talbot et al, 2017; Witt & Bulger, 2017). Occupant protection in motor vehicle crashes has improved considerably over previous eras, but rib fracture rates have seen only marginal reductions during this time and remain as the most common serious injury in multiple crash scenarios (Forman et al, 2019; Pipkorn et al, 2020). With changing population demographics, there is further concern not just with increased rib fracture frequency with age, but also with higher resulting mortality and morbidity in the elderly and other vulnerable populations (Sirmali et al, 2003; Stawicki et al, 2004).…”

Section: Introductionmentioning

confidence: 99%

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Rib cortical bone thickness variation in adults by age and sex

Holcombe

Derstine

2022

Journal of Anatomy

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Rib fractures are a common and serious outcome of blunt thoracic trauma and their likelihood is greater in older individuals. Osteoporotic bone loss is a well-documented aging phenomenon with sex-specific characteristics, but within rib bones, neither baseline maps of regional thickness nor the rates of bone thinning with age have been quantified across whole ribs. This study presents such data from 4014 ribs of 240 adult subjects aged 20-90. A validated cortical bone mapping technique was applied to clinical computed tomography scans to obtain local rib cortical bone thickness measurements over the surfaces of ribs 2 through 11. Regression models to age and sex gave rates of cortex thinning in local zones and aggregated across whole ribs. The statistical parametric mapping provided these relationships regionally as a function of rib surface location. All models showed significant reductions in bone thickness with age (p < 0.01). Average whole-rib thinning occurred at between 0.011 to 0.032 mm/ decade (males) and 0.035 to 0.043 mm/decade (females), with sex and age accounting for up to 37% of population variability (R 2 ). Rates of thinning differed regionally and by rib, with the highest bone loss of up to 0.074 mm/decade occurring in mid-rib cutaneous and superior regions of ribs 2-6. Rates were consistently higher in females than males (significantly so across whole ribs but not all local regions) and were more pronounced in cutaneous, superior, and inferior rib aspects (average 0.025 mm/decade difference in ribs 4-8) compared to pleural aspects which had the thickest cortices but saw only minor differences in thinning rates by sex (0.045 mm/decade for females and 0.040 mm/decade for males). Regional analysis showed male and female bone thickness differences that were not statistically significant at 20 years of age (p > 0.05 across practically all regions) but subsequent cortex thinning meant that substantial pleural and cutaneous regions were thinner (p < 0.05) in females than males by 55 years of age. The techniques and results from this study can be applied to assess rib bone content loss in clinical settings across wide populations. Additionally, average cortex thickness results can be mapped directly to finite element models of the thorax, and regression results are used to modify such models to represent the ribs of men and women across their full adult lifespan.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Rib cortical bone thickness variation in adults by age and sex

Holcombe

Derstine

2022

Journal of Anatomy

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“…Therefore, the current study was carried out to investigate the frequency of injury types and different body regions involved for females and males. In contrast to other studies focused on vehicle occupants ( Pipkorn et al, 2020 ), the current study focuses on pedestrians and cyclists in collisions involving passenger cars.…”

Section: Introductionmentioning

confidence: 99%

Are There Any Significant Differences in Terms of Age and Sex in Pedestrian and Cyclist Accidents?

Leo

Rizzi

Bos

et al. 2021

Front. Bioeng. Biotechnol.

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This study has analyzed sex-specific differences in pedestrian and cyclist accidents involving passenger cars. The most frequently injured body regions, types of injuries, which show sex-specific differences and the general accident parameters of females and males were compared. Accident data from three different European countries (Austria, Netherlands, Sweden) were analyzed. The current analysis shows that for both, females and males, pedestrian and cyclist injuries are sustained mainly to the body regions head, thorax, upper extremities and lower extremities. The results show that the odds for sustaining skeletal injuries to the lower extremities (incl. pelvis) in females are significantly higher. It was observed in all datasets, that the odds of females being involved in a rural accident or an accident at night are lower than for males. Elderly pedestrian and cyclist (≥60YO) tend to sustain more severe injuries (AIS2+ and AIS3+) than younger pedestrian and cyclists (<60YO) in some of the datasets. The findings of this study highlight the differences in males and females in both, accident scenarios and sustained injuries. Further investigations are needed to distinguish between gender- and sex-specific differences causing the different injury patterns.

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“…First, the PDOF was only described through 4 categories of accident type in our database, which may oversimplify the exact PDOF. It has been shown that oblique impacts have their own mechanisms and injury patterns [38], however this category does not exist in our database.…”

Section: Discussionmentioning

confidence: 85%

When epidemiological databases inform injury mechanisms: biomechanical analysis of injury associations

et al. 2023

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Background Vehicle accidents are still a heavy social burden despite improvements due the latest technologies and policies. To pursue the trend of decrease, having a more detailed view and understanding of the injury patterns would contribute to inform both the rescue team to optimize victim’s management and policymakers in order for them to tackle at best this issue. Methods Two complementary analyses of injury associations were performed, one using a biomechanical classification and the other an anatomic one, computed on data stratified by car accident type (lateral or frontal). Our objective is to understand whether these two categories of crash lead to similar or heterogeneous injury association patterns, and analyze these findings from an impact mechanics point of view. Indeed, having an improved understanding of the injury mechanisms would facilitate their diagnosis and prevention. Results While each type of accident possesses its own injury profile, most injury associations are found for both types. Injuries such as clavicle and rib fractures were identified as involved in a high number of associations. Several associations between fractures and blood vessel injuries were found. Conclusions The results suggests three main conclusions: (i) Injury associations are rather independent from crash characteristics, (ii) Clavicle and rib fractures are typical of poly-traumatized victims, (iii) Certain fractures can be used to early detect victims at higher risk of hemorrhage. Overall, this study provide paramedics and doctors with data to orientate them toward a faster and more appropriate decision. Moreover, this exploratory work revealed the potential that injury association analyses have to inform policy-making and issue recommendations to decrease road accident mortality and morbidity.

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Occupant injuries in light passenger vehicles—A NASS study to enable priorities for development of injury prediction capabilities of human body models

Cited by 18 publications

References 10 publications

Rib cortical bone thickness variation in adults by age and sex

Rib cortical bone thickness variation in adults by age and sex

Are There Any Significant Differences in Terms of Age and Sex in Pedestrian and Cyclist Accidents?

When epidemiological databases inform injury mechanisms: biomechanical analysis of injury associations

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