Ryb Gabriel E, Burch Cynthia, Kerns Timothy, Dischinger Patricia C, Ho Shiu
Charles C Mathias, Jr National Study Center for Trauma and EMS, University of Maryland, Baltimore, Maryland 21201, USA.
J Trauma. 2010 May;68(5):1099-105. doi: 10.1097/TA.0b013e3181d9a751.
To establish whether the Insurance Institute for Highway Safety (IIHS) offset crash test ratings are linked to different mortality rates in real world frontal crashes.
The study used Crash Injury Research Engineering Network drivers of age older than 15 years who were involved in frontal crashes. The Crash Injury Research Engineering Network is a convenience sample of persons injured in crashes with at least one Abbreviated Injury Scale score of 3+ injury or two Abbreviated Injury Scale score of 2+ injuries who were either treated at a Level I trauma center or died. Cases were grouped by IIHS crash test ratings (i.e., good, acceptable, marginal, poor, and not rated). Those rated marginal were excluded because of their small numbers. Mortality rates experienced by these ratings-based groups were compared using the Mantel-Haenszel chi test. Multiple logistic regression models were built to adjust for confounders (i.e., occupant, vehicular, and crash factors).
A total of 1,226 cases were distributed within not rated (59%), poor (12%), average (16%), and good (14%) categories. Those rated good and average experienced a lower unadjusted mortality rate. After adjustment by confounders, those in vehicles rated good experienced a lower risk of death (adjusted OR 0.38 [0.16-0.90]) than those in vehicles rated poor. There was no significant effect for "acceptable" rating. Other factors influencing the occurrence of death were age, DeltaV >or=70 km/h, high body mass index, and lack of restraint use.
After adjusting for occupant, vehicular, and crash factors, drivers of vehicles rated good by the IIHS experienced a lower risk of death in frontal crashes.
确定美国公路安全保险协会（IIHS）偏置碰撞测试评级是否与现实世界中正面碰撞的不同死亡率相关。
本研究使用了碰撞损伤研究工程网络中15岁以上参与正面碰撞的驾驶员。碰撞损伤研究工程网络是一个便利样本，包括在碰撞中受伤、至少有一个简略损伤量表评分为3级以上损伤或两个简略损伤量表评分为2级以上损伤、在一级创伤中心接受治疗或死亡的人员。病例按IIHS碰撞测试评级（即良好、可接受、边缘、差和未评级）分组。由于数量较少，将评级为边缘的排除。使用Mantel-Haenszel卡方检验比较这些基于评级的组的死亡率。建立多元逻辑回归模型以调整混杂因素（即乘员、车辆和碰撞因素）。
共有1226例病例分布在未评级（59%）、差（12%）、中等（16%）和良好（14%）类别中。评级为良好和中等的未调整死亡率较低。在通过混杂因素调整后，评级为良好的车辆中的人员死亡风险（调整后的比值比为0.38[0.16 - 0.90]）低于评级为差的车辆中的人员。“可接受”评级没有显著影响。影响死亡发生的其他因素包括年龄、DeltaV≥70公里/小时、高体重指数和未使用约束装置。
在调整乘员、车辆和碰撞因素后，IIHS评级为良好的车辆驾驶员在正面碰撞中的死亡风险较低。
