Correlating the extent of pulmonary contusion to vehicle crash parameters in near-side impacts

Pulmonary contusion (PC) is the most common injury following blunt thoracic trauma with an associated mortality of 10% to 20%. The purpose of this study is to determine how crash parameters correlate to the volume of pulmonary contusion. The Crash Injury Research Engineering and Network (CIREN) database was queried to extract data on all occupants sustaining PC in a near-side crash. The selected CIREN data included all completed cases from 2005 through 2010. Cases involving a roll-over or without a thorax CT uploaded to the database were excluded. After all cases had been examined the study had 64 occupants with varying volumes of PC. Specific crash characteristics compiled included change in velocity due to the impact, energy, occupant characteristics, side airbag deployment, and crush profile measurements. Crush metrics quantifying the area of the crush profile and the location of the crush relative to the occupant were calculated. The thoracic CT scans from these cases were downloaded and segmented to determine the percent volume of high attenuation lung and PC as compared to the total volume of the lung. The results of the general linear model analysis suggest that maximum crush was the best predictor of high attenuation lung and lung location best predicted PC. An analysis of NASS and CIREN demonstrated that crashes with PC tended to have crash parameters that indicated higher severity. These correlations can be used in the future to develop an injury criterion for PC using finite element metrics.