Importance of mortality from head injury in immediate survivors of vehicular injuries

Gennarelli, Thomas A.; Champion, Howard R.; Copes, Wayne S.

Affiliations

¹Division of Neurosurgery, University of Pennsylvania, Philadelphia,Pennsylvania

²Trauma Service, Washington Hospital Center, Washington, D.C.

Abstract

Analysis of 174,160 patients admitted to 165 trauma centers in the United States was undertaken to compare mortality of those injured by vehicular mechanisms with non-vehicular causes. Vehicular injuries (49.7%) were divided into those to vehicle occupants (VO, 36.4%), pedestrians (PED, 7.2%) and motorcyclists (MC, 6.0%) while non-vehicular injuries were subdivided into penetrating (gunshot (8.7%). stabbings (8.0%) and other (1.8Oh)) and blunt (falls (18.4%), assaults (13.2%)) causes. Each injury was categorized by severity by AIS-85 and by the presence of injury to the skull or brain (head injuries = HI). Of the 59,713 HI, vehicular causes produced more head injures (66.6%) than all other causes, despite the preponderance of non-vehicular injuries in the overall series (50.3%). For each of the vehicular injuries, HI mortality was higher than if no head injury (NHI) occurred: VO 11.5% v. 4.9%: PED 20.7% v. 7.3%; MC 15.3% v. 4.2% for HI and NHI respectively. This was also true for each AIS level. Analysis of these mortality rates, combined with the frequency of their occurrence, measures overall importance of each combination of HI and NHI in vehicular crashes. The greatest “vehicular mortality harm” in immediate survivors of crashes is caused by VO with HI of AIS = 3-6 who also have extracranial injuries of AIS = 3 severity. This group has three times the importance of any PED group and almost six times the importance of any MC group. These data can be used to target injury reduction strategies.

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Cited By (4)

Year	Entry
1992	Gennarelli TA, Champion HR, Copes WS. Mortality of head injuries in immediate survivors of vehicular crashes. In: 36th Annual Proceedings, Association for the Advancement of Automotive Medicine (AAAM). October 5-7, 1992; Portland, OR.289-202.
1998	Lawson AR, Sadeghi MM. Finite element modelling of blunt or non-contact head injuries. In: Proceedings of the 16th International Technical Conference on the Enhanced Safety of Vehicles (ESV). May 31–June 4, 1998; Windsor, Ontario, Canada.2080-2092.
1994	Ruan JS. Impact Biomechanics of Head Injury by Mathematical Modeling [PhD thesis]. Detroit, MI: Wayne State University; 1994.
1995	Zhou C. Finite Element Modeling of Impact Response of an Inhomogeneous Brain [PhD thesis]. Detroit, MI: Wayne State University; 1995.