Correlation between crash severity, injury severity, and clinical course in car occupants with thoracic trauma: A technical and medical study

Background:: The crash mechanisms and clinical course of car occupants with thoracic injury were analyzed to determine prognostic factors and to creat e a basis for injury prophylaxis. Methods: A technical and medical investigation of car occupants with a thor acic injury (Abbreviated Injury Scale-thorax [AIS(THORAX)] greater than or equal to 1) at the scene of the crash and the primary admitting hospital wa s performed, Results: Between 1985 and 1998, 581 car occupants sustained a thoracic inju ry. Mean parameter values were as follows: AIS(THORAX) 2.5; Hannover Polytr auma Score (PTS), 21.4; Injury Severity Score (ISS), 24.2; Delta-v, 49.6 km /h (30.8 mph); and extent of passenger compartment deformation (DEF) (scale , 1-9), 4.0, In 19% (n = 112) of patients involved, the clinical course was evaluated: AIS(THORAX) 2.5; PTS, 20.0; ISS, 19.3; Delta-v, 50.1 km/h (31.1 mph); DEF, 3.9; intensive care unit time, 8.3 days; ventilation time, 5.7 days; and hospital stay, 15.3 days. In the groups with higher AIS(THORAX) I SS, PTS, and intensive care unit and ventilation time, higher DeIta-v and D EF occurred. In patients with longer hospital stay, higher Delta-v, but no difference in DEF occurred, Conclusion: The injury severity and the clinical course demonstrated a posi tive correlation with the crash severity. Therefore, our technical accident analysis allows prediction of the severity of injury and the clinical cour se; It may consequently serve as a tool for development of more sophisticat ed injury prevention strategies and may improve passive car safety.