Japan Automobile Research Institute, 2530 Karima, Tsukuba, Ibaraki, 305-0822, Japan.
Umeå University, SE-901 87, Umeå, Sweden.
Accid Anal Prev. 2018 Aug;117:98-105. doi: 10.1016/j.aap.2018.04.009. Epub 2018 Apr 19.
This study estimated the frequency and risk of Moderate-to-Maximal traumatic brain injuries sustained by occupants in motor vehicle crashes in the US. National Automotive Sampling System - Crashworthiness Data System crashes that occurred in years 2001-2015 with light vehicles produced 2001 or later were incorporated in the study. Crash type, crash severity, car model year, belt usage and occupant age and sex were controlled for in the analysis. The results showed that Moderate concussions account for 79% of all MAIS2+ injuries. Belted occupants were at lower risks than unbelted occupants for most brain injury categories, including concussions. After controlling for the effects of age and crash severity, belted female occupants involved in frontal crashes were estimated to be 1.5 times more likely to sustain a concussion than male occupants in similar conditions. Belted elderly occupants were found to be at 10.5 and 8 times higher risks for sub-dural haemorrhages than non-elderly belted occupants in frontal and side crashes, respectively. Adopted occupant protection strategies appear to be insufficient to achieve significant decreases in risk of both life-threatening brain injuries and concussions for all car occupants. Further effort to develop occupant and injury specific strategies for the prevention of brain injuries are needed. This study suggests that these strategies may consider prioritization of life-threatening brain vasculature injuries, particularly in elderly occupants, and concussion injuries, particularly in female occupants.
本研究估计了美国机动车碰撞中乘员遭受中度至重度创伤性脑损伤的频率和风险。纳入了 2001 年至 2015 年期间发生的、使用 2001 年以后生产的轻型车辆的国家汽车抽样系统碰撞事故数据系统的事故。在分析中控制了碰撞类型、碰撞严重程度、汽车型号年份、安全带使用情况以及乘员年龄和性别。结果表明,中度脑震荡占所有 MAIS2+损伤的 79%。与未系安全带的乘员相比,系安全带的乘员在大多数脑损伤类别中(包括脑震荡)的风险较低。在控制年龄和碰撞严重程度的影响后,正面碰撞中系安全带的女性乘员比处于类似条件的男性乘员更有可能遭受脑震荡,风险估计值为 1.5 倍。研究发现,在正面和侧面碰撞中,老年系安全带的乘员发生硬膜下血肿的风险比非老年系安全带的乘员分别高 10.5 倍和 8 倍。采用的乘员保护策略似乎不足以显著降低所有汽车乘员发生危及生命的脑损伤和脑震荡的风险。需要进一步努力制定针对特定乘员和损伤的预防脑损伤策略。本研究表明,这些策略可能需要考虑优先处理危及生命的脑血管损伤,特别是在老年乘员中,以及脑震荡损伤,特别是在女性乘员中。
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