Evans Susan L, Nance Michael L, Arbogast Kristy B, Elliott Michael R, Winston Flaura K
Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
J Trauma. 2009 Feb;66(2):504-7. doi: 10.1097/TA.0b013e318166d295.
Passenger compartment intrusion, loss of integrity of the vehicle occupant compartment due to a motor vehicle crash, has frequently been used as a triage criterion. Data to support intrusion as a proxy for injury severity in child occupants are lacking. The purpose of this study was to examine the association between intrusion and injury to children in motor vehicle crashes.
Crash investigation data were reviewed from the partners for child passenger safety database, a large, child-focused crash surveillance system. Data included: intrusion (centimeters), direction of impact, age of occupant, and Abbreviated Injury Scale (AIS) score. Analyses examined the relationship between the amount of intrusion and the risk of any AIS > or = 2, or > or = 3 injury.
Data were available on 880 children, age 0 year to 15 years. AIS > or = 2 and > or = 3 injuries occurred in 40.3% and 12.6% of child occupants, respectively. Intrusion was strongly and positively associated with the odds of both an AIS > or = 2 and > or = 3 injury (p < 0.0001). The odds of at least one AIS > or = 2, or > or = 3 injury increased on average by 2.9% (95% CI = 1.9-3.8%), or 4.0% (95% CI = 2.7-5.2%), respectively, for each additional centimeter of intrusion, adjusting for age, restraint use, seating row, and direction of impact.
The association between passenger compartment intrusion and injury in children supports its application in triage, and usefulness in injury predictive models. Future studies should determine methods for providing valid field information on intrusion to the trauma team.
乘客舱侵入，即机动车碰撞导致车辆乘员舱完整性丧失，常被用作分诊标准。缺乏支持将侵入作为儿童乘员损伤严重程度替代指标的数据。本研究的目的是探讨机动车碰撞中侵入与儿童损伤之间的关联。
回顾了儿童乘客安全数据库合作伙伴的碰撞调查数据，该数据库是一个大型的、以儿童为重点的碰撞监测系统。数据包括：侵入程度（厘米）、撞击方向、乘员年龄和简略损伤量表（AIS）评分。分析研究了侵入量与任何AIS≥2或≥3损伤风险之间的关系。
有880名0至15岁儿童的数据。分别有40.3%和12.6%的儿童乘员发生了AIS≥2和≥3损伤。侵入与AIS≥2和≥3损伤的几率均呈强烈正相关（p<0.0001）。在调整年龄、约束系统使用情况、座位排数和撞击方向后，侵入每增加1厘米，至少发生一次AIS≥2或≥3损伤的几率平均分别增加2.9%（95%CI=1.9-3.8%）或4.0%（95%CI=2.7-5.2%）。
乘客舱侵入与儿童损伤之间的关联支持其在分诊中的应用以及在损伤预测模型中的有用性。未来的研究应确定向创伤团队提供侵入有效现场信息的方法。
