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To evaluate whether older injured motor vehicular crash (MVC) occupants' access to trauma centers (TC) reflects the lower threshold suggested in triaging recommendations.

To examine the association of scene mobility status (SMS) and injury severity and mortality among motor vehicular crash (MVC) victims.

Motor vehicle collisions (MVCs) are the leading cause of spine and spinal cord injuries in the United States. Traumatic cervical spine injuries (CSIs) result in significant morbidity and mortality. This study was designed to evaluate both the epidemiologic and biomechanical risk factors associated with CSI in MVCs by using a population-based database and to describe occupant and crashes characteristics for a subset of severe crashes in which a CSI was sustained as represented by the Crash Injury Research Engineering Network (CIREN) database.

To establish whether the Insurance Institute for Highway Safety (IIHS) offset crash test ratings are linked to different mortality rates in real world frontal crashes.

To study whether trauma center patients with positive toxicology findings for cocaine-positive (COC) are at a higher risk for suicide, homicide, and unintentional injury death after discharge than cocaine-negative (COC) trauma patients.

Pulmonary contusions (PCs) are a common injury sustained in motor vehicle collisions. The crash and occupant characteristics of PC in motor vehicle collisions are currently unknown. Additionally, the clinical significance and the impact on mortality have not been determined.

To compare injury patterns and outcomes of near- and far-side collisions.

The purpose of this analysis was to determine which of the initial symptoms after mild traumatic brain injury (MTBI) can best predict the development of persistent postconcussive syndrome (PCS).

To investigate the association of history of school suspension (HSS) to risky behaviors and injury history.

This study investigates the influence of overweight and obesity on outcome from vehicular trauma.

To measure the combined contribution of change in velocity (v), principal direction of force (PDOF), and restraint use on mortality after vehicular trauma.

Numerous reports document that preinjury alcohol use is associated with all modes of injury requiring treatment in a trauma center, with 25% to 50% or more of patients testing positive for alcohol at the time of admission. There is evidence that in trauma patients unaddressed alcohol use problems result in recurrent injury requiring readmission to a trauma center and/or death.

Despite advances in automotive safety, pelvic fractures caused by motor vehicle collisions remain a significant cause of mortality, morbidity, and functional disability. This study was designed to evaluate epidemiologic and biomechanic risk factors associated with pelvic fractures resulting from motor vehicle collisions. We utilized the Crash Injury Research Engineering Network (CIREN) database to identify these risk factors in newer vehicles.

To investigate the correlation between motor vehicle crash mechanisms and pelvic injury in front-seat occupants, we retrospectively reviewed the clinical records of, and had complete crash reconstructions performed for, 145 vehicular trauma patients with Injury Severity Scores greater than 16 admitted to a level I trauma center. After excluding rear-seat and ejected occupants, 44 of the remaining 115 patients had pelvic injuries. We excluded acetabular fractures and classified the remaining 26 pelvic ring fractures by the system of Young and Burgess: 20 lateral compression (LC) fractures, five anteroposterior compression (APC) fractures, and one combined mechanical injury (CMI) fracture. Eighteen pelvic fractures were managed conservatively; eight required surgical intervention and four of those eight required emergent application of an external fixator for unresponsive hypotension. Trained investigation teams conducted the crash reconstructions, evaluating crash sites and vehicles with direct measurements of more than 500 variables. Calculations from these data, e.g., direction of impact and change in velocity at impact (ΔV), were made with the CRASH III computer program and statistical analyses were performed using Chi-square and ttests. This information was then merged with the orthopedic evaluations. We found that: (1) 72 of the pelvic fractures occurred in automobiles with gross vehicular weights less than 2700 lb (compact and subcompact) (p= 0.05); (2) the ΔV was lower for lateral impacts than for frontal impacts (24 mph vs. 32 mph, respectively; p= 0.0005); (3) more victims of lateral than frontal impacts suffered pelvic fractures (50 vs. 7.5, respectively, p= 0.0001); (4) more victims of lateral than frontal impacts suffered LC injuries (83 vs. 17, respectively; p< 0.0001); and (5) LC-II and LC-III fractures tended to occur at higher ΔVs than did LC-I fractures (29.0 mph vs. 23.5 mph, respectively). We concluded that there was a direct correlation between pelvic injury and vehicular mechanism of injury, substantiating the pelvic injury classification system of Young and Burgess, and that there is a need for additional side impact protection in motor vehicles.