Winston Flaura Koplin, Kallan Michael J, Senserrick Teresa M, Elliott Michael R
The Children's Hospital of Philadelphia, 3535 Market St, Ste 1150, Philadelphia, PA 19104, USA.
Arch Pediatr Adolesc Med. 2008 Mar;162(3):253-60. doi: 10.1001/archpediatrics.2007.52.
To identify and prioritize risk factors for passenger death.
Retrospective cohort captured in 2 databases: US census of fatal crashes (Fatality Analysis Reporting System) and US-representative sample of police-reported crashes (National Automotive Sampling System Crash Data System).
Crashes in 50 states and the District of Columbia from January 1, 2000, to December 31, 2005.
A total of 45 560 passengers aged 8 to 17 years in crashes, representing 2 545 168 passengers (weighted). Main Exposures Age and sex of driver, vehicle and road type, restraint use, seating position, day of week, month, time of day, and speed limit. Outcome Measure Passenger fatality.
Approximately 424 000 passengers (aged 8-17 years) annually were in tow-away crashes and experienced a fatality rate of 3.9 per 1000. Just more than three-quarters as many passengers (aged 8-17 years) were in crashes with 16- to 19-year-old drivers as with all adult drivers (those aged > or =25 years), with double the passenger fatality rate. For drivers aged 16 to 17 years, passenger fatalities doubled between passenger ages 11 to 12 years and increased to a peak at a passenger age of 16 years. Of crashes with child passenger fatality, 21.2% involved alcohol. In crashes with drivers younger than 18 years, the greatest risk factors for death for passengers aged 8 to 17 years were drivers younger than 16 years, restraint nonuse, and high-speed roads (> or =55 and 45-54 mph).
While passenger risks because of restraint nonuse require continued attention, interventions must be developed to address risk because of travel on high-speed roads and riding with drivers younger than 16 years. For safety, child passengers and their parents should monitor these characteristics of the drive and the driver. Anticipatory guidance about passenger risks should begin by the age of 11 years.
识别乘客死亡的风险因素并确定其优先级。
在两个数据库中进行回顾性队列研究：美国致命车祸普查（死亡分析报告系统）和美国警方报告车祸的代表性样本（国家汽车抽样系统碰撞数据系统）。
2000年1月1日至2005年12月31日期间美国50个州和哥伦比亚特区发生的车祸。
共有45560名年龄在8至17岁之间的乘客遭遇车祸，代表2545168名乘客（加权）。主要暴露因素包括驾驶员的年龄和性别、车辆及道路类型、安全带使用情况、座位位置、星期几、月份、一天中的时间以及限速。结局指标为乘客死亡。
每年约有42.4万名年龄在8至17岁之间的乘客遭遇需拖走的车祸，死亡率为每1000人中有3.9人死亡。年龄在8至17岁之间的乘客中，与16至19岁驾驶员发生车祸的人数仅略多于与所有成年驾驶员（年龄≥25岁）发生车祸人数的四分之三，但乘客死亡率却是后者的两倍。对于年龄在16至17岁的驾驶员，乘客死亡人数在乘客年龄从11至12岁之间翻倍，并在乘客年龄为16岁时增至峰值。在有儿童乘客死亡的车祸中，21.2%涉及酒精。在与18岁以下驾驶员发生的车祸中，年龄在8至17岁之间的乘客死亡的最大风险因素是驾驶员年龄小于16岁、未使用安全带以及高速道路（限速≥55英里/小时和45 - 54英里/小时）。
虽然因未使用安全带导致的乘客风险仍需持续关注，但必须制定干预措施以应对因在高速道路上行驶以及与年龄小于16岁的驾驶员同乘所带来的风险。为了安全起见，儿童乘客及其父母应留意驾驶过程和驾驶员的这些特征。关于乘客风险的预期指导应在11岁时开始。
