Cardiac disease and driver fatality.

Area of Science:

• Forensic Pathology
• Cardiovascular Research
• Traffic Safety

Background:

• Cardiac disease is a leading cause of death globally.
• The role of cardiac events in motor vehicle accidents requires further investigation.
• Driver demographics are shifting towards an older population.

Purpose of the Study:

• To investigate the prevalence of cardiac disease in drivers who died in motor vehicle accidents.
• To compare the incidence of coronary artery atherosclerosis (CAA) and cardiomegaly in drivers versus passengers.
• To determine if cardiac disease contributes to driver fatalities in crashes.

Main Methods:

• Retrospective review of autopsy files from Forensic Science SA (Adelaide, Australia) from January 2005 to December 2017.
• Analysis included drivers aged ≥40 years who died while driving.
• Comparison group: passengers aged ≥40 years who died of trauma; drivers aged ≥40 years who died of a cardiac event while driving.

Main Results:

• Among drivers who died of trauma (n=303), 15.8% had CAA and 10.2% had cardiomegaly.
• These rates were not statistically different from passengers (n=72) who died of trauma (20.8% CAA, 15.2% cardiomegaly; p>0.2).
• A distinct subgroup of 63 drivers died from cardiac events, not trauma, while driving.

Conclusions:

• Significant coronary artery atherosclerosis and cardiomegaly were not associated with increased driver fatalities in motor vehicle crashes.
• A notable subgroup of drivers died from primary cardiac events while operating a vehicle.
• The incidence of drivers dying from cardiac events while driving may increase with an aging population.