Nirula R, Pintar F A
Division of Trauma/Burns/Critical Care, University of Texas Southwestern Medical Center, Dallas, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA.
Accid Anal Prev. 2008 Jan;40(1):137-41. doi: 10.1016/j.aap.2007.04.013. Epub 2007 Jun 4.
Thoracic trauma secondary to motor vehicle crashes (MVC) continues to be a major cause of morbidity and mortality. Specific vehicle features may increase the risk of severe thoracic injury when striking the occupant. We sought to determine which vehicle contact points were associated with an increased risk of severe thoracic injury in MVC to focus subsequent design modifications necessary to reduce thoracic injury.
The National Automotive Sampling System (NASS) databases from 1993 to 2001 and the Crash Injury Research and Engineering Network (CIREN) databases from 1996 to 2004 were analyzed separately using univariate and multivariate logistic regression stratified by restraint use and crash direction. The risk of driver thoracic injury, defined as an abbreviated injury scale (AIS) of score > or =3, was determined as it related to specific points of contact between the vehicle and the driver.
The incidence of severe chest injury in NASS and CIREN were 5.5% and 33%, respectively. The steering wheel, door panel, armrest, and seat were identified as contact points associated with an increased risk of severe chest injury. The door panel and arm rest were consistently a frequent cause of severe injury in both the NASS and CIREN data.
Several vehicle contact points, including the steering wheel, door panel, armrest and seat are associated with an increased risk of severe thoracic injury when striking the occupant. These elements need to be further investigated to determine which characteristics need to be manipulated in order to reduce thoracic trauma during a crash.
机动车碰撞（MVC）导致的胸部创伤仍然是发病和死亡的主要原因。特定的车辆特征在撞击驾乘人员时可能会增加严重胸部损伤的风险。我们试图确定在机动车碰撞中哪些车辆接触点与严重胸部损伤风险增加相关，以便聚焦后续为减少胸部损伤所需的设计改进。
分别使用单变量和多变量逻辑回归分析1993年至2001年的国家汽车抽样系统（NASS）数据库以及1996年至2004年的碰撞损伤研究与工程网络（CIREN）数据库，并按约束使用情况和碰撞方向进行分层。确定驾驶员胸部损伤的风险（定义为简略损伤量表（AIS）评分≥3）与车辆和驾驶员之间的特定接触点的关系。
NASS和CIREN中严重胸部损伤的发生率分别为5.5%和33%。方向盘、车门面板、扶手和座椅被确定为与严重胸部损伤风险增加相关的接触点。车门面板和扶手在NASS和CIREN数据中一直是严重损伤的常见原因。
几个车辆接触点，包括方向盘、车门面板、扶手和座椅，在撞击驾乘人员时与严重胸部损伤风险增加相关。需要对这些部件进行进一步研究，以确定为减少碰撞期间的胸部创伤需要控制哪些特性。
