Newgard Craig D, Lewis Roger J, Kraus Jess F, McConnell K John
Center for Policy and Research in Emergency Medicine, Department of Emergency Medicine, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Mail Code CR-114, Portland, OR 97239-3098, USA.
Accid Anal Prev. 2005 Jul;37(4):668-74. doi: 10.1016/j.aap.2005.03.008. Epub 2005 Apr 2.
Previous studies have suggested that motor vehicle occupants seated on the near-side of a lateral impact have a higher proportion of thoracoabdominal injuries. However, due to limitations in previous studies, the true association between seat position, side of lateral impact, and thoracoabdominal injury is unclear.
To assess the relationship between seat position (i.e., near-side, middle-seat, and far-side, regardless of row), side of lateral motor vehicle crash (MVC), and serious thoracoabdominal injury after adjusting for important crash factors.
National population-based cohort of adult subjects involved in MVCs and included in the National Automotive Sampling System Crashworthiness Data System database (NASS CDS) from 1995 to 2003.
Occupants aged > or =16 years involved in MVCs where the highest external deformation of the vehicle was located on the right or left side (i.e., lateral).
Serious thoracic or abdominal injury, defined as an Abbreviated Injury Scale (AIS) > or =3 in the thoracic or abdominal body region.
Fifteen thousand, one hundred and sixty persons involved in primary lateral MVCs were represented in the NASS CDS database during the 9-year period. There were 1867 (2%) persons with serious thoracic injuries and 507 persons (0.5%) with serious abdominal injuries. In multivariable logistic regression models that adjusted for important crash factors and the NASS CDS sampling design, seat position was a strong effect modifier of the association between side of lateral impact and serious thoracic (p<0.0001) and abdominal (p=0.0009) injury, with the risk of serious thoracic and abdominal injury highest for occupants seated on the near-side of the crash. The mean probability of injury was higher for near-side and middle-seat occupants compared to far-side occupants, and the probability of thoracic injury was approximately four times higher than that of abdominal injury for all seat positions.
There is a strong, synergistic relationship between seat position and side of lateral MVC in assessing risk of serious thoracic and abdominal injury among adult occupants. The probability of serious thoracoabdominal injury increases with increasing proximity of seat position to side of the crash and the risk of thoracic injury is higher than abdominal injury for all seat positions.
先前的研究表明，在侧面碰撞中坐在近侧的机动车乘客胸腹损伤的比例较高。然而，由于先前研究存在局限性，座位位置、侧面碰撞的方向与胸腹损伤之间的真实关联尚不清楚。
在对重要碰撞因素进行校正后，评估座位位置（即近侧、中间座位和远侧，不分排）、机动车侧面碰撞（MVC）的方向与严重胸腹损伤之间的关系。
基于全国人口的成年受试者队列研究，这些受试者参与了MVC，并被纳入1995年至2003年的国家汽车抽样系统碰撞安全性数据系统数据库（NASS CDS）。
年龄≥16岁的机动车乘客，所乘车辆的最大外部变形位于右侧或左侧（即侧面）。
严重胸腹部损伤，定义为胸腹部区域的简明损伤定级（AIS）≥3。
在9年期间，NASS CDS数据库中有15160人参与了初次侧面MVC。有1867人（2%）发生严重胸部损伤，507人（0.5%）发生严重腹部损伤。在对重要碰撞因素和NASS CDS抽样设计进行校正的多变量逻辑回归模型中，座位位置是侧面碰撞方向与严重胸部（p<0.0001）和腹部（p=0.0009）损伤之间关联的强效应修饰因素，对于坐在碰撞近侧的乘客，严重胸腹损伤的风险最高。与远侧乘客相比，近侧和中间座位乘客的平均受伤概率更高，并且在所有座位位置，胸部损伤的概率大约是腹部损伤概率的四倍。
在评估成年乘客严重胸腹损伤风险时，座位位置与侧面MVC的方向之间存在强烈的协同关系。严重胸腹损伤的概率随着座位位置与碰撞侧距离的减小而增加，并且在所有座位位置，胸部损伤的风险高于腹部损伤。
