Impact of vehicular data on trauma outcomes after motor vehicle crashes

Field triage guidelines exist to inform first responder personnel on criteria to expedite the transfer of motor vehicle collision (MVC) patients to trauma centers; however, these guidelines are minimally informed by the vehicle characteristics and collision characteristics. Given this, we studied associations of the vehicle characteristics and collision characteristics with patient injury and outcomes.

We conducted a retrospective study using Michigan State Police crash reports linked with Michigan Trauma Quality Improvement Program collaborative quality initiative data. Univariable analysis was used to identify characteristics predictive of the primary outcome of severe injury, defined as an Injury Severity Score >15 (ISS>15), and multivariable logistic regression analysis was performed across primary and secondary outcomes of ISS>15, mortality, and the need for surgery, intensive care, or transfer to another hospital.

There were 13 154 linked cases between the two data sources. This contained 52.3% males with a mean age of 41.7 years (SD 20.7 years). In multivariable logistic regression, the collision characteristics associated with the highest increased odds of ISS>15 were single-vehicle crashes (OR 1.35, p<0.01) and head-on crashes (OR 1.54, p<0.01). Head-on crashes (OR 1.60, p<0.01) and single-vehicle crashes (OR 1.46, p=0.03) were associated with a significantly increased risk of mortality. Head-on crashes (OR 1.49, p<0.01) and single-vehicle crashes (OR 1.37, p<0.01) were associated with the highest odds of operative intervention or intensive care.

Several vehicle and collision characteristics are associated with increased odds of severe traumatic injury and death after MVC. The addition of these characteristics to field triage assessments could improve triage decision-making to predict injury severity and the risk of mortality.

III, prognostic, epidemiological.