Risk factors for pelvic fractures in lateral impact motor vehicle crashes

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Abstract

Lateral impact motor vehicle crashes account for over 10% of all crashes and are more likely to result in pelvic fractures than frontal crashes. We performed a case control study of lateral impact motor vehicle crashes using the 1995–2004 National Accident Sampling System Crashworthiness Data System to determine occupant and vehicle risk factors for pelvic fractures. Cases (N = 728) were occupants involved in a near-side lateral impact crash who experienced a pelvic fracture and controls were occupants (N = 5710) who did not experience a pelvic fracture. Occupant risk factors evaluated were age, body mass index (BMI), gender including pregnancy status, and seat belt use. Vehicle risk factors evaluated were vehicle body type, weight of striking and struck vehicles, and magnitude of intrusion of side or door panel. Using multivariate logistic regression analysis, we found that age 65 years or older, female gender, underweight body mass index, and increasing magnitude of intrusion of the door or side panel of the vehicle were associated with an increased risk of a pelvic fracture. Injury prevention strategies should focus on decreasing the magnitude of side or door panel intrusion to decrease the risk of pelvic fracture in the event of a lateral impact crash.

Introduction

Lateral impact motor vehicle crashes account for 11.7% of all crashes (Samaha and Elliott, 2003) and can result in significant injury to the vehicle occupants. Compared to frontal crashes, lateral impact crashes are more likely to result in pelvic fractures (Stein et al., 2006). Pelvic injury occurs in 12% of lateral impact crashes, resulting in more than 15,000 pelvic fractures annually in the USA (Samaha and Elliott, 2003). Several prior studies have evaluated occupant risk factors in lateral impact motor vehicle crashes and found increasing age (Mofatt and Mitter, 1990), and low body mass index to be associated with pelvic fracture. Female gender has also been associated with risk of pelvic fracture (Mofatt and Mitter, 1990, Stein et al., 2006, Rowe et al., 2004) but no prior studies have evaluated pregnancy as a potential risk factor. A prior biomechanical study (Tencer et al., 2005) noted that magnitude of intrusion of the side or door panel of the vehicle was associated with injury severity of the pelvis but did not specifically evaluate pelvic fracture. We performed a case control study of motor vehicle crashes using a national motor vehicle crash database to determine occupant and vehicle risk factors for pelvic fractures occurring in lateral impact crashes.

Section snippets

Material and methods

The National Highway Traffic Safety Administration collects information on a sample of all motor vehicle crashes reported to police in the United States. Approximately 5000 crashes are investigated annually by trained investigators and the crash data are entered in the National Accident Sampling System Crashworthiness Data System (CDS). We evaluated the CDS data for all occupants aged 18 years and older who were involved in lateral vehicle crashes in which they experienced a near-side impact

Results

During the 10 years study period, we found 728 occupants involved in near-side lateral impact crashes that sustained a pelvic fracture and compared them to 5710 occupants without a pelvic fracture. Occupants with a pelvic fracture were more likely to be 65 years of age or older, non-pregnant females, shorter in height, leaner in weight, and underweight as classified by BMI, and less likely to wear a seat belt compared to occupants with no pelvic fracture (Table 1).

Vehicle characteristics also

Discussion

Among near-side occupants involved in a lateral impact motor vehicle crash, we found that the strongest risk factor for pelvic fracture was the magnitude of intrusion of the door or side panel of the vehicle, with the greatest risk among those with the greatest magnitude of intrusion. We also found that age 65 years or older, female gender, and underweight BMI were also associated with an increased risk of a pelvic fracture in these lateral crashes.

The factor most strongly associated with risk

Acknowledgments

This research was supported by grant R49/CE000197 from the National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta GA.

References (9)

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