Injury analysis of patients according to impact patterns involved in pedestrian traffic crashes

ABSTRACT

Objectives: In cases of car-to-person pedestrian traffic crashes (PTCs), the principal issue is determining at what point the car collided with the pedestrian. Accordingly, the objective of the present study was to use the medical records of patients injured in PTCs to investigate the characteristics of crash types and the areas and injury severity and to determine whether there are differences in injuries due to the angle, motion, and position at the point of impact.

Methods: The present study examined 231 PTC patients admitted to the emergency room (ER) between January and December 2014. Electronic medical records from the hospital were used to divide the patient data according to Abbreviated Injury Scale (AIS) codes for injured areas based on sex, age, time of the crash, outcomes after ER treatment, and major symptoms. Among 231 patients, police reports on 67 crash cases, involving 70 people, were obtained with the help of local police departments, and these reports were used to reconstruct details of the actual crash. For statistical analysis, a chi-square test and a one-way analysis of variance calculation were used to compare the Injury Severity Score (ISS) based on groups and stages, with a statistical significance level set to P < .05.

Results: With respect to patients who were admitted for PTC, 52.4% were females and 47.6% were males. The frequency of crashes was high in middle-aged and elderly groups, as well as for youths between 10 and 19 years old. With respect to outcomes after ER treatment, discharge to home after symptom improvement was the most common outcome (24.6%). Admissions to the intensive care unit (25.1%) and to the general ward (23.8%) were also high. In terms of major symptoms, the most common injuries were to the head, resulting from a rotatory motion post impact (35.9%), and injuries to the legs, resulting from the impact of a direct collision with an object (25.1%).

Conclusions: This study demonstrated that injuries to the chest and abdomen were the most severe in the fender vault group and head and neck injuries were the most severe in the roof vault group. In particular, the Injury Severity Score was highest in the roof vault group.

KEYWORDS:

• Pedestrian
• injury severity
• pedestrian impact pattern
• crash reconstruction

Funding

This research was supported by the Korea Ministry of Land, Infrastructure and Transport, the Korea Agency for Infrastructure Technology Advancement (Project No. 16PTSI-C054118-08), and the National Forensic Service (Project No. NFS2017TAA02).