Citation

Figler BD, Mack CD, Kaufman R, Wessells H, Bulger E, Smith TG, Voelzke B. J. Trauma Acute Care Surg. 2014; 76(3): 750-754.

Affiliation

From the University of Washington Departments of Urology (B.F., H.W., B.V.) and Surgery (R.K., E.B.), University of Washington, Harborview Injury Prevention and Research Center, Harborview Medical Center; Group Health Research Institute (C.D.M.), Seattle, Washington; Scott Department of Urology (T.G.S.), Baylor College of Medicine, Ben Taub General Hospital, Houston, Texas.

Copyright

(Copyright © 2014, Lippincott Williams and Wilkins)

DOI

10.1097/TA.0b013e3182aafd5b

PMID

24553544

Abstract

BACKGROUND: The National Highway Traffic Safety Administration's New Car Assessment Program (NCAP) implemented side-impact crash testing on all new vehicles since 1998 to assess the likelihood of major thoracoabdominal injuries during a side-impact crash. Higher crash test rating is intended to indicate a safer car, but the real-world applicability of these ratings is unknown. Our objective was to determine the relationship between a vehicle's NCAP side-impact crash test rating and the risk of major thoracoabdominal injury among the vehicle's occupants in real-world side-impact motor vehicle crashes. METHODS: The National Automotive Sampling System Crashworthiness Data System contains detailed crash and injury data in a sample of major crashes in the United States. For model years 1998 to 2010 and crash years 1999 to 2010, 68,124 occupants were identified in the Crashworthiness Data System database. Because 47% of cases were missing crash severity (ΔV), multiple imputation was used to estimate the missing values. The primary predictor of interest was the occupant vehicle's NCAP side-impact crash test rating, and the outcome of interest was the presence of major (Abbreviated Injury Scale [AIS] score ≥ 3) thoracoabdominal injury. RESULTS: In multivariate analysis, increasing NCAP crash test rating was associated with lower likelihood of major thoracoabdominal injury at high (odds ratio [OR], 0.8; 95% confidence interval [CI], 0.7-0.9; p < 0.01) and medium (OR, 0.9; 95% CI, 0.8-1.0; p < 0.05) crash severity (ΔV), but not at low ΔV (OR, 0.95; 95% CI, 0.8-1.2; p = 0.55). In our model, older age and absence of seat belt use were associated with greater likelihood of major thoracoabdominal injury at low and medium ΔV (p < 0.001), but not at high ΔV (p ≥ 0.09). CONCLUSION: Among adults in model year 1998 to 2010 vehicles involved in medium and high severity motor vehicle crashes, a higher NCAP side-impact crash test rating is associated with a lower likelihood of major thoracoabdominal trauma. LEVEL OF EVIDENCE: Epidemiologic study, level III.

Language: en