Factors influencing vehicle passenger fatality have changed over 10 years: a nationwide hospital-based study
DOI: 10.1038/s41598-020-60222-z
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Summary
This study investigates how the factors influencing vehicle passenger fatalities in motor vehicle collisions (MVCs) have evolved over a decade in Japan. While technological advancements and safety improvements have reduced overall MVC mortality, the specific clinical and demographic predictors of death may have shifted. The authors aimed to identify these changing factors using nationwide hospital-based data, a perspective previously unexplored in studies that relied primarily on police or crash databases. Understanding these trends is critical for establishing effective preventive measures as traffic injury patterns change alongside an aging population. The researchers conducted a retrospective observational study using data from the Japanese Trauma Data Bank (JTDB), a national registry covering approximately 75% of critical care centers in Japan. The study included vehicle passengers (including drivers) aged 15 and older with an Abbreviated Injury Scale (AIS) of 3 or more, excluding those who arrived with cardiopulmonary arrest or had missing data. Two distinct time periods were compared: Period A (2004–2008, n=4,684) and Period B (2016–2017, n=3,690). Multivariate logistic regression analyses were performed to determine independent predictors of fatality within each period, comparing fatal and non-fatal outcomes based on demographics, vital signs, injury severity scores, and pre-hospital/in-hospital treatment data. The results indicated a significant demographic shift, with patients in Period B being older (mean age 52.7 vs. 45.1 years) and having a higher proportion of females. Overall fatality rates decreased significantly from 7.9% in Period A to 4.3% in Period B, accompanied by improved physiological parameters and reduced injury severity in most body regions, except for the chest and spine. In Period A, independent predictors of fatality included male sex, front-seat passenger status, older age, lower diastolic blood pressure, lower body temperature, lower Glasgow Coma Scale (GCS) scores, and higher AIS scores for the neck and abdomen. In contrast, Period B predictors shifted to male sex, older age, lower GCS scores, higher abdominal AIS scores, and positive focused assessment with sonography for trauma (FAST) results. Notably, front-seat status and neck injury severity were no longer significant independent predictors in the later period. The study concludes that while overall MVC survivability has improved due to better vehicle safety, road conditions, and trauma care systems, the profile of fatal injuries has changed. The emergence of FAST positivity as a predictor in the later period suggests that internal bleeding remains a critical determinant of survival despite other improvements. The findings highlight that preventive strategies and clinical assessments must adapt to the aging population and evolving injury mechanisms. As traffic safety technologies continue to advance, the factors influencing fatality will likely continue to evolve, necessitating ongoing evaluation of medical data to guide effective interventions.
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| Stage | Outcome | Tool | Model | Prompt | Attempts | Completed |
|---|---|---|---|---|---|---|
| discover | success | Crossref | — | — | 1 | 2026-06-24 |
| archive | success | canonical_url | — | — | 1 | 2026-06-26 |
| extract | success | cached | — | — | 2 | 2026-06-26 |
| clean | success | clean | — | — | 1 | 2026-06-25 |
| chunk | success | chunk | — | — | 1 | 2026-06-25 |
| embed | success | embed | Qwen/Qwen3-Embedding-8B | — | 1 | 2026-06-25 |
| promote | success | — | — | — | 1 | 2026-06-24 |
| summarize | success | llm | qwen3.6-27b-prismaquant | summ-v5 | 1 | 2026-06-26 |
| tag | success | vector_similarity | — | — | 6 | 2026-06-25 |
| verify | success | — | — | — | 1 | 2026-06-26 |
Summary generated by qwen3.6-27b-prismaquant on 2026-06-26; verification: verified.
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- Empirical Findings: crash risk outcomes