Annals of advances in automotive medicine / Annual Scientific Conference ... Association for the Advancement of Automotive Medicine. Association for the Advancement of Automotive Medicine. Scientific Conference
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Ann Adv Automot Med · Oct 2009
Comparative StudyDynamic biomechanics of the human head in lateral impacts.
The biomechanical responses of human head (translational head CG accelerations, rotational head accelerations, and HIC) under lateral impact to the parietal-temporal region were investigated in the current study. Free drop tests were conducted at impact velocities ranging from 2.44 to 7.70 m/s with a 40 durometer, a 90 durometer flat padding, and a 90 durometer cylinder. Specimens were isolated from PMHS subjects at the level of occipital condyles, and the intracranial substance was replaced with brain simulant (Sylgard 527). ⋯ At the skull fracture, HIC values were more than 2-3x higher than the frontal skull fracture threshold (HIC=1000), emphasizing the differences between frontal and lateral impact. Rotational head accelerations up to 42.1 krad/s(2) were observed before skull fracture, indicating possible severe brain injury without skull fracture in lateral head impact. These data will help to establish injury criteria and threshold in lateral impacts for improved automotive protection and help clinicians understand the biomechanics of lateral head impact from improved diagnosis.
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Ann Adv Automot Med · Oct 2009
Comparative StudyA study of impairing injuries in real world crashes using the Injury Impairment Scale (IIS) and the predicted Functional Capacity Index (PFCI-AIS).
The ability to predict impairment outcomes in large databases using a simplified technique allows researchers to focus attention on preventing costly impairing injuries. The dilemma that exists for researchers is to determine which method is the most reliable and valid. This study examines available methods to predict impairment and explores the differences between the IIS and pFCI applied to real world crash injury data. ⋯ These data were selected from a previous study conducted between 2003 and 2006 and identified the discrepancy between predicted impairment and actual perceived impairment as defined by the participant. Overall the work highlights the variation between the pFCI and IIS and emphasises the importance and need for a single validated impairment scale that can be universally applied. This would allow emphasis to be directed towards preventing injuries that are associated with the most significant impairment outcomes.
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Previous studies have demonstrated that booster seats reduce the risk of abdominal injuries by improving the fit of the seat belt on young children and encouraging better posture and compatibility with the vehicle seat. Recently, several studies have reported cases of abdominal injuries in booster seated children questioning the protective effects of these restraints. The objective of this study was to examine cases of abdominal injuries in booster seated children through parametric modeling to gain a thorough understanding of the injury causation scenarios. ⋯ Children in two of the cases sustained a thoracic injury (AIS 3/AIS 4) in addition to their abdominal injuries (AIS 2) and review of these cases pointed to the role of shoulder belt loading in the injury causation. Modeling of these cases revealed chest compressions and accelerations of 30-53 mm and 41-89 g, respectively and abdominal deflection and velocity of 7.0-13.3 mm and 1.2-2.2 m/s, respectively. Parametric study suggested that coupling shoulder belt load limiting and lap belt buckle pretensioning resulted in improved chest and abdominal metrics while reducing head excursion, indicating that these technologies may provide injury reduction potential to pediatric rear seat occupants.
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Rib fractures may be dismissed as clinically insignificant, or of secondary importance in a patient presenting with other serious injuries, especially if the patient is young. This study assesses the effect of concomitant rib injuries on fatality risk following a car crash, and compares the effect as a function of patient age. The National Trauma Databank was sampled to identify 181,331 adults that were in motor vehicle crashes and had complete data available. ⋯ For older patients (over 64 years) the odds ratio was 2.5 (95% CI 2.3-2.8). In other words, regardless of the presence or absence of concomitant trauma, crash-injured patients with rib fractures of at least AIS 3 have a significantly increased risk of in-hospital mortality, and of two patients having similar non-rib trauma, one with AIS 3+ rib fractures has a substantially higher expected risk of death than one without. This effect is more dramatic for older patients.
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Ann Adv Automot Med · Oct 2008
Accuracy of ICD-9-CM coding of cervical spine fractures: implications for research using administrative databases.
ICD-9-CM codes are often used for trauma research due to their ready availability in administrative databases. They are also used to classify injury severity in trauma patients. However, errors in coding may limit the use of these codes. Prior studies have found coding accuracy ranging from 20 to 100%, casting doubt on the reliability of studies utilizing these codes. The goal of this study was to determine the accuracy of ICD-9-CM coding for cervical spine fractures. ⋯ We found an overall 94% accuracy of ICD-9-CM coding compared to radiology reports. Inaccuracy of coding fracture level ranged from 7 to 14%. Researchers using these codes should refer back to the medical record or perform a sensitivity analysis to improve reliability.