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远侧碰撞中受约束前排乘客的碰撞特征和损伤模式。

Crash characteristics and injury patterns of restrained front seat occupants in far-side impacts.

作者信息

Yoganandan Narayan, Arun Mike W J, Halloway Dale E, Pintar Frank A, Maiman Dennis J, Szabo Aniko, Rudd Rodney W

机构信息

a Department of Neurosurgery , Medical College of Wisconsin , Milwaukee , Wisconsin.

出版信息

Traffic Inj Prev. 2014;15 Suppl 1(0 1):S27-34. doi: 10.1080/15389588.2014.935771.

Abstract

OBJECTIVE

The study was conducted to determine the association between vehicle-, crash-, and demographic-related factors and injuries to front seat far-side occupants in modern environments.

METHODS

Field data were obtained from the NASS-CDS database for the years 2009-2012. Inclusion factors included the following: adult restrained front outboard-seated occupants, no ejection or rollovers, and vehicle model years less than 10 years old at the time of crash. Far-side crashes were determined by using collision deformation classification. Injuries were scored using the Abbreviated Injury Scale (AIS). Injuries (MAIS 2+, MAIS 3+, M denotes maximum score) were examined based on demographics, change in velocity, vehicle type, direction of force, extent zone, collision partner, and presence of another occupant in the front seat. Only weighted data were used in the analysis. Injuries to the head and face, thorax, abdomen, pelvis, and upper and lower extremity regions were studied. Odds ratios and upper and lower confidence intervals were estimated from multivariate analysis.

RESULTS

Out of 519,195 far-side occupants, 17,715 were MAIS 2+ and 4,387 were MAIS 3+ level injured occupants. The mean age, stature, total body mass, and body mass index (BMI) were 40.7 years, 1.7 m, 77.2 kg, and 26.8 kg/m2, respectively. Of occupants with MAIS 2+ injuries, 51% had head and 19% had thorax injuries. Of occupants with MAIS 3+ injuries, 50% had head and 69% had thorax injuries. The cumulative distribution of changes in velocities at the 50th percentile for the struck vehicle for all occupants and occupants with MAIS 2+ and MAIS 3+ injuries were 19, 34, and 42 km/h, respectively. Furthermore, 73% of MAIS 2+ injuries and 86% of MAIS 3+ injuries occurred at a change in velocity of 24 km/h or greater. Odds of sustaining MAIS 2+ and MAIS 3+ injuries increased with each unit increase in change in velocity, stature, and age, with one exception. Odds of sustaining injuries were higher with the presence of an occupant in the front seat at the MAIS 3+ level, although it was reversed at the lower level. The extent zone of 3+ increased the odds compared to the extent zones of 1 to 2 at both MAIS 2+ and MAIS 3+ injuries. Odds ratios and confidence intervals are given.

CONCLUSIONS

The findings are as follows: head and thorax are the more frequently injured body regions, and the prevalence of cranium injuries is similar at both injury severities; thoracic injuries are more prevalent at the MAIS 3+ level; the presence of another front seat occupant plays a role in MAIS 3+ trauma; injuries continue to occur at changes in velocity representative of side impact environments; and mean demographic factors are close to mid-size automotive anthropometry, indicating the need to pursue this line of study. Because data were gathered from only 4 years, it would be important to include additional NASS-CDS database years, rescore injuries from previous years, and analyze other international databases to reinforce these findings for advancing safety for far-side occupants.

摘要

目的

本研究旨在确定在现代环境中,与车辆、碰撞及人口统计学相关的因素与前排远侧乘客受伤情况之间的关联。

方法

从2009 - 2012年的国家汽车抽样系统 - 碰撞数据系统(NASS - CDS)数据库中获取现场数据。纳入因素包括:成年且系安全带的前排外侧座位乘客、未弹出车外或发生翻车、碰撞时车辆车龄小于10年。通过碰撞变形分类确定远侧碰撞。使用简略损伤评分(AIS)对损伤进行评分。基于人口统计学、速度变化、车辆类型、受力方向、损伤区域、碰撞对象以及前排座位是否有其他乘客等因素,对损伤(MAIS 2 +、MAIS 3 +,M表示最高评分)进行研究。分析中仅使用加权数据。对头面部、胸部、腹部、骨盆以及上下肢区域的损伤情况进行研究。通过多变量分析估计比值比以及上下置信区间。

结果

在519,195名远侧乘客中,17,715名乘客的损伤程度为MAIS 2 +,4,387名乘客为MAIS 3 +级损伤。平均年龄、身高、总体重和体重指数(BMI)分别为40.7岁、1.7米、77.2千克和26.8千克/平方米。在MAIS 2 +级损伤的乘客中,51%头部受伤,19%胸部受伤。在MAIS 3 +级损伤的乘客中,50%头部受伤,69%胸部受伤。所有乘客以及MAIS 2 +和MAIS 3 +级损伤乘客的被撞车辆速度变化的第50百分位数处的累积分布分别为19、34和42千米/小时。此外,73% 的MAIS 2 +级损伤和86% 的MAIS 3 +级损伤发生在速度变化24千米/小时及以上时。每单位速度变化、身高和年龄的增加,发生MAIS 2 +和MAIS 3 +级损伤的几率都会增加,但有一个例外。在MAIS 3 +级时,前排座位有其他乘客会增加受伤几率,不过在较低级别时情况相反。与损伤区域1至2相比,损伤区域3 +在MAIS 2 +和MAIS 级损伤时都会增加几率。给出了比值比和置信区间。

结论

研究结果如下:头部和胸部是更常受伤的身体部位,且在两种损伤严重程度下颅骨损伤的发生率相似;MAIS 3 +级时胸部损伤更为普遍;前排座位有其他乘客在MAIS 3 +级创伤中起作用;在代表侧面碰撞环境的速度变化时仍会发生损伤;平均人口统计学因素接近中型汽车人体测量学,表明有必要继续开展这方面研究。由于数据仅收集了4年,纳入更多年份的NASS - CDS数据库、重新对以往年份的损伤进行评分以及分析其他国际数据库以强化这些发现,对于提高远侧乘客的安全性很重要。

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