与机动车事故中老年驾驶员相关的道路特征。
Roadway features associated with elderly drivers in motor vehicle crashes.
机构信息
From the Wraparound Project, Department of Surgery (M.P., A.N.), University of California, San Francisco; Program on Health, Equity and Sustainability (S.S., D.M., M.W.), San Francisco Department of Public Health; and Department of Surgery, Trauma and Surgical Critical Care (R.E.P.), University of California, San Francisco, San Francisco, California.
出版信息
J Trauma Acute Care Surg. 2021 Feb 1;90(2):313-318. doi: 10.1097/TA.0000000000003034.
BACKGROUND
As the number of older US drivers has increased over the past decades, so has the number of injuries, hospitalizations, and deaths from motor vehicle crashes (MVCs) involving elderly drivers. We seek to identify personal, environmental, and roadway features associated with increased crashes involving elderly drivers. We hypothesize that elderly drivers are more likely to be involved in MVCs at intersections with more complex signage and traffic flow.
METHODS
This is a retrospective observational study using 2015 to 2019 police traffic crash reports and a Department of Public Health database of built-environment variables from a single urban center. Demographics and environmental/road features were compared for vehicle-only MVCs involving elderly (≥65 years) and younger drivers. χ2 and nonparametric tests were used to analyze 36,168 drivers involved in MVCs.
RESULTS
There were 2,575 (7.1%) elderly drivers involved in MVCs during the study period. Left turns and all-way stop signs were associated with increased crash risk among elderly drivers compared with younger drivers. Elderly-involved MVCs were less likely to occur at intersections with left-turn restrictions, traffic lights, only one-way streets, and bike lanes compared with MVCs with younger drivers. Elderly drivers were more likely to be involved in MVCs on weekdays, less often intoxicated at the time of the crash, and less frequently involved in fatal MVCs compared with younger drivers. However, elderly drivers were more frequently the at-fault party, especially after the age of 75 years.
CONCLUSION
Updates to roadway features have potential to decrease injury and death from MVCs involving elderly adults. Left turn restrictions or other innovative safety treatments at all-way stops or where left turns are permitted may mitigate road crashes involving older adults. Education may increase awareness of higher-risk driving tasks such as turning left, and driving alternatives including public transportation/paratransit may offer alternate means to maintain activities of daily living.
LEVEL OF EVIDENCE
Prognostic/Epidemiological, level IV.
背景
在过去几十年中，随着美国老年司机数量的增加，涉及老年司机的车辆碰撞事故（MVC）的受伤、住院和死亡人数也有所增加。我们试图确定与老年司机碰撞事故增加相关的个人、环境和道路特征。我们假设，在交通标志和交通流更为复杂的交叉口，老年司机更有可能发生 MVC。
方法
这是一项使用 2015 年至 2019 年警方交通碰撞报告和一个单一城市中心的公共卫生部门构建环境变量数据库的回顾性观察研究。对涉及老年（≥65 岁）和年轻司机的车辆单独 MVC 的人口统计学和环境/道路特征进行了比较。使用 χ2 和非参数检验分析了涉及 36168 名司机的 MVC。
结果
在研究期间，有 2575 名（7.1%）老年司机参与了 MVC。与年轻司机相比，左转和所有方式停车标志与老年司机的碰撞风险增加相关。与年轻司机的 MVC 相比，老年司机参与的 MVC 较少发生在设有左转限制、交通信号灯、单行道和自行车道的交叉口。与年轻司机相比，老年司机更有可能在工作日发生 MVC，在碰撞时醉酒的可能性较小，并且不太可能发生致命 MVC。然而，与年轻司机相比，老年司机更有可能成为事故的责任方，尤其是在 75 岁以上。
结论
更新道路特征有可能减少涉及老年成年人的 MVC 造成的伤害和死亡。在所有方式停车或允许左转的地方实施左转限制或其他创新安全措施可能会减轻涉及老年人的道路碰撞。教育可能会提高对诸如左转等高风险驾驶任务的认识，公共交通/代客运输等替代方案可能提供替代手段来维持日常生活活动。
证据水平
预后/流行病学，IV 级。
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