University of Michigan Transportation Research Institute, 2901 Baxter Rd., Ann Arbor, MI 48109-2150, United States.
Accid Anal Prev. 2010 Nov;42(6):2140-3. doi: 10.1016/j.aap.2010.07.005. Epub 2010 Aug 4.
Older occupants in motor-vehicle crashes are more likely to experience injury than younger occupants. One possible reason for this is that increasing age is associated with increased prevalence of osteoporosis, which decreases bone strength. Crash-injury data were used with Bayes' Theorem to estimate the conditional probability of AIS 3+ skeletal injury given that an occupant is osteoporotic for the injury to the head, spine, thorax, lower extremities, and upper extremities. This requires the conditional probabilities of osteoporosis given AIS 3+ injury for each of the body regions, which were determined from analysis of the Crash Injury Research and Engineering Network database. It also requires information on probability of osteoporosis in the crash-involved population and the probabilities of AIS 3+ skeletal injury to different body regions in crashes. The latter probabilities were obtained from the National Automotive Sampling System-Crashworthiness Data System (NASS-CDS) database. The former was obtained by modeling the probability of osteoporosis in the US populations using data from the 2006 National Health Examination Nutrition Survey and applying this model to the estimate of the crash-involved population in NASS-CDS. To attempt to account for the effects of age on injury outcome that are independent of osteoporosis, only data from occupants who were 60 years of age or older were used in all analyses. Results indicate that the only body region that experiences a statistically significant change in fracture injury risk with osteoporosis is the spine, for which osteoporosis increases the risk of AIS 3+ fracture by 3.28 times, or from 0.41% to 1.34% (p<0.0001). This finding suggests that the increase in AIS 3+ injury risk with age for non-spine injuries is likely influenced by factors other than osteoporosis.
在汽车碰撞中，老年乘客比年轻乘客更容易受伤。一个可能的原因是，随着年龄的增长，骨质疏松症的发病率也会增加，从而降低了骨骼的强度。使用贝叶斯定理和碰撞伤害数据来估算发生 AIS 3+骨骼伤害的条件概率，即假定乘客患有骨质疏松症时，头部、脊柱、胸部、下肢和上肢的伤害概率。这需要确定每个身体部位的骨质疏松症发生 AIS 3+伤害的条件概率，这些概率是从 Crash Injury Research and Engineering Network 数据库的分析中确定的。还需要有关在碰撞中涉及的人群中骨质疏松症的概率信息，以及在碰撞中不同身体部位 AIS 3+骨骼伤害的概率。后一种概率是从 National Automotive Sampling System-Crashworthiness Data System (NASS-CDS) 数据库中获得的。前者是通过使用来自 2006 年全国健康检查营养调查的数据对美国人口中骨质疏松症的概率进行建模，并将该模型应用于 NASS-CDS 中涉及碰撞的人群的估计值来获得的。为了尝试解释与骨质疏松症无关的受伤结果的年龄影响，仅在所有分析中使用 60 岁或以上的乘客数据。结果表明，只有脊柱是骨质疏松症导致骨折受伤风险发生统计学显著变化的身体部位，骨质疏松症使 AIS 3+骨折的风险增加 3.28 倍，即从 0.41%增加到 1.34%（p<0.0001）。这一发现表明，非脊柱损伤的 AIS 3+受伤风险随年龄的增加很可能受到骨质疏松症以外的因素的影响。
