Motor Vehicle-Related Trauma at a Level 1 Trauma Center, in New York

Author(s): Bharti Sharma, Aubrey May B. Agcon, George Agriantonis, Samantha Kiernan, Navin D. Bhatia, Kate Twelker, Jasmine Dave, Juan Mestre, Zahra Shafaee, Jennifer Whittington

Background: Despite advancements in technology and safety measures, injuries involving motor vehicles remain common. Therefore, our goal is to examine the relationship between various factors (such as age, gender, race, ethnicity, alcohol consumption, mental health, helmet usage, and others) and injuries resulting from motor vehicle collisions (MVCs).

Methods: We conducted a retrospective cohort study of patients who sustained injuries in MVCs at a Level 1 Trauma Center from 2016 to 2023, inclusive. All analyses were performed with the help of the inbuilt statistical tools available in SAS.

Result: Over 8 years, we identified 536 patients with MVCs-related trauma. The mean age of the cohort was 42.3. Out of the total, 116 (21.6%) individuals were older than 60 years, while 37 (6.9%) were 18 years or younger. The majority (80.4%) involved multi-body region injuries, with 431 occurrences, Single-body region injuries accounted for 19.6% of the cases, totaling 105 occurrences. In most cases, the head had the highest Abbreviated Injury Severity (AIS) score with a mean of 3.7, followed by the thorax with a mean of 2.8. The mean hospital length of stay (LOS) was 12.8 days, whereas ICU LOS was 4.8 days. Out of the entire cohort, 54 (10.1%) had a history of alcoholism, 20 (3.7%) had psychiatric disturbances, and another 20 (3.7%) patients had a history of substance use disorders. The cause of injury involved pedestrians struck by a vehicle (44%), followed by motorcycle crashes (25.2%), bicycle crashes (18.7%), and motor vehicle crashes (9.3%). 99.63 % of patients had blunt trauma, and 0.37% had penetrating trauma. The majority of the injured population were skateboarders, roller skaters, or bladers (44.03%), followed by motorcycle crashes (MCC) (25.19%), bicycles (18.66%), motor vehicle crashes (MVC) (9.33%) and struck by motor vehicle (2.8%). Drivers (48.13%) were highly injured as compared to passengers (8.21%). In the analysis of helmet usage, 30.2% of patients who were required to be equipped with helmets did not use them, while only 11.0% used helmets; in 3.73% of cases, required helmet usage was unknown. 162 riders without helmets had an average Injury Severity Score (ISS) of 20.3, and a high head AIS score of ≥3.

Conclusion: Based on various age ranges, young adults in their 20s suffered serious MVCs-associated injuries. The majority were pedestrians, skateboarders, roller skaters, or inline skaters, followed by bicyclists, motorcyclists, and car occupants. Many of the injured individuals were not equipped with helmets. Patients suffered more severe injuries as well as longer hospital and ICU stays than those who used helmets. There were significantly more males in the cohort than females. Most cases involved injuries to multiple parts of the body and had blunt-type trauma. The presence of alcohol, psychoactive substances, or other intoxicants in the blood was strongly associated with higher injury severity.

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