[Forensic expertise of the injury severity in fatally injuried car-occupants]

There is no specific injury among fatally injured frontal car-occupants in frontal car collisions, used in forensic expertise. We tried to point out the usefulness of the Abbreviated Injury Scale (AIS) and Injury Severity Score (ISS) for the expertise in such cases.

Analyzing the severity of body region injuries and total injury severity of deceased car occupants, to point out their importance in forensic expertise.

Retrospective autopsy study was performed. Autopsy records of all deceased car-occupants in frontal car collisions were analyzed in order to establish the severity of injuries in body regions (AIS) and total severity of injuries (ISS). Statistical analysis was performed using the chi-square test, t-test, and logistic regression, with significance set at p < 0.05.

A total of 500 cases were analyzed: 282 car-drivers and 218 front car-passengers, average age of 41.48 +/- 15.31 and 39.78 +/- 16.93. There were 401 males and 99 females. The most injured body region was head with neck: AIS = 3.50 +/- 2.48, for car-drivers, and AIS = 3.54 +/- 2.50, for front car-passengers, as well as thorax: AIS = 3.63 +/- 2.16 car-drivers, and AIS = 3.37 +/- 2.14, for front car-passengers. More severe injuries of head (AIS > or =4) suggested that deceased was a front car-passenger (Wald = 13.27; p = 0.04). More severe injuries of thorax and abdomen (AIS > or =5) indicated that deceased was a car-driver (Wald = 5.72; p = 0.02, and Wald = 8.23; p = 0.01, respectively). The injury severity of the face and limbs were useless in such expertise (Wald = 1.72; p = 0.19, and Wald =0.89; p = 0.34, respectively). An average ISS was 57.31 +/- 20.16 for car-drivers, and 54.54 +/- 21.01 for front car-passengers. The ISS value was useless in expertise (t=1.50; p = 0.13, and Wald = 2.24; p = 0.13).

As the injury of the head is more severe, the deceased is more likely to be the front car-passenger. Severe thoracic and abdominal injuries are more characteristic for car-drivers. A total injury severity is useless for forensic expertise in cases of fatally injured in car collisions.