Ryb Gabriel E, Dischinger Patricia C, Braver Elisa R, Burch Cynthia A, Ho Shiu M, Kufera Joseph A
Charles C. Mathias, Jr., National Study Center for Trauma and EMS, University of Maryland, Baltimore, Maryland 21201, USA.
J Trauma. 2009 Feb;66(2):499-503. doi: 10.1097/TA.0b013e3181615626.
To compare injury patterns and outcomes of near- and far-side collisions.
Near- and far-side occupants in the Crash Injury Research and Engineering Network (CIREN) were compared for mortality and the occurrence of severe injuries (maximum abbreviated injury scale [MAIS] 3+). Regression models, adjusting for confounders, examined death and MAIS 3+ injuries as outcomes and near- or far-side position as an independent variable. CIREN findings were compared with those of the Crash Outcome Data Evaluation System (CODES), and the Maryland Automated Accident Reporting System.
Of the 380 cases, 72% were in the near and 28% in the far position. Mortality was similar between groups within CIREN. Near-side occupants experienced a higher frequency of MAIS 3+ injuries for the thorax, abdomen, and lower extremities, and fewer MAIS 3+ head injuries than far-side occupants (35% vs. 46%, p = 0.06). Regression models revealed similar risk of MAIS 3+ head injuries among near- and far-side occupants. The most common structures contacting the head in far-side crashes (N = 62) were opposite side structures (52%) and other occupants (13%). Similar risks of head injuries among near- and far-side occupants were observed for the CODES data; however, lower risks of death were present among far-side drivers involved in crashes, based on CODES and Maryland Automated Accident Reporting System.
Despite a lower incidence of thoracic, abdominal, and lower extremity injuries, far-side occupants experienced a similar risk of head injuries to that of near-side occupants. Contact patterns suggest that restraint systems fail to keep far-side occupants' heads from striking opposite side structures or other occupants.
比较近侧碰撞和远侧碰撞的损伤模式及后果。
对碰撞损伤研究与工程网络（CIREN）中的近侧和远侧驾乘人员的死亡率及重伤（最高简略损伤量表[MAIS] 3+）发生率进行比较。采用回归模型，对混杂因素进行校正，以死亡和MAIS 3+损伤作为结局，近侧或远侧位置作为自变量进行分析。将CIREN的研究结果与碰撞结局数据评估系统（CODES）以及马里兰州自动事故报告系统的结果进行比较。
在380例病例中，72%为近侧碰撞，28%为远侧碰撞。CIREN组内各群体的死亡率相似。近侧驾乘人员胸部、腹部和下肢MAIS 3+损伤的发生率高于远侧驾乘人员，而MAIS 3+头部损伤的发生率低于远侧驾乘人员（35%对46%，p = 0.06）。回归模型显示，近侧和远侧驾乘人员发生MAIS 3+头部损伤的风险相似。在远侧碰撞（N = 62）中，与头部接触的最常见结构是对侧结构（52%）和其他驾乘人员（13%）。对于CODES数据，近侧和远侧驾乘人员头部受伤的风险相似；然而，根据CODES和马里兰州自动事故报告系统的数据，发生碰撞的远侧驾驶员的死亡风险较低。
尽管远侧驾乘人员胸部、腹部和下肢损伤的发生率较低，但其头部受伤的风险与近侧驾乘人员相似。接触模式表明，约束系统未能防止远侧驾乘人员的头部撞击对侧结构或其他驾乘人员。
