ROLE OF DISEASE IN INITIATING THE CRASHES OF FATALLY INJURED DRIVERS

All autopsied car drivers (n = 480) aged greater than or equal to 18 y ears, who were fatally injured and died within 3 days of the crash in northern Sweden over a 13-year period were studied. A grading system w as developed to assess the probability of contribution of intrinsic me dical factors to the crash. This system takes into account both the ri sk of sudden incapacitation (inability to cope), based on intrinsic me dical factors revealed in the medical history and at autopsy, and extr insic non-medical contributing factors. Almost one quarter of the driv ers were found to have intrinsic medical factors. Intrinsic medical fa ctors were more common in males than in females. Drivers with intrinsi c medical factors were often at fault and usually crossed over to the wrong side of the road and crashed into an oncoming vehicle or roadsid e object. In 6% of the drivers, intrinsic medical factors were probabl y the underlying cause of the crash; in 1.3% the probability was stron g. In the greater than or equal to 60-year-old group, intrinsic medica l factors were the underlying cause of the crash in 19% of the cases; the probability was strong in 4%. Copyright (C) 1996 Elsevier Science Ltd