Navigating Risk: A Comprehensive Study on Pedestrian-Vehicle Collision Factors.

Area of Science:

• Trauma Surgery
• Public Health
• Epidemiology

Background:

• Commonly held beliefs suggest older adults, young children, and individuals with psychiatric illnesses are most vulnerable to pedestrian-vehicle collisions.
• Empirical evidence supporting these beliefs is limited, necessitating a data-driven investigation into risk factors.

Purpose of the Study:

• To identify risk factors associated with being a pedestrian struck by a motor vehicle (PSMV) among trauma patients.
• To analyze the comparative risk of PSMV across different age groups (children, adolescents, adults, elderly).

Main Methods:

• Utilized the 2017-2021 Trauma Quality Improvement Program database for blunt trauma patients.
• Compared patients who were pedestrians struck by vehicles (PSMV) with those experiencing other blunt trauma mechanisms.
• Performed multivariable logistic regression to identify predictors of PSMV and age-related risk differences.

Main Results:

• Out of over 4.7 million blunt trauma patients, 3.7% were PSMV, exhibiting higher rates of lung injuries, rib fractures, and overall complications.
• Substance use disorder (OR 2.13) and alcohol use disorder (OR 1.21) were the strongest independent risk factors for PSMV.
• Children (OR 0.87) and elderly patients (OR 0.36) were found to be less likely to be PSMV compared to adult patients.

Conclusions:

• Substance use disorders and psychiatric illness are significant predictors of PSMV, challenging traditional assumptions about vulnerable populations.
• The lower incidence of PSMV in children and the elderly warrants a re-evaluation of prevention strategies.
• Increased complications and mortality associated with PSMV underscore the critical need for enhanced pedestrian and driver awareness and primary prevention initiatives.