Risk factors for pelvic fractures in lateral impact motor vehicle crashes
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.
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