Abdominopelvic injuries due to road traffic accidents: Characteristics in a registry of 162,695 victims

Monchal, Tristan; Ndiaye, Amina; Gadegbeku, Blandine; Javouhey, Etienne; Monneuse, Olivier · 2018 · Crossref

DOI: 10.1080/15389588.2018.1447669

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Summary

This study investigates the epidemiology, characteristics, and risk factors of abdominopelvic injuries (APIs) resulting from road traffic accidents (RTAs). Motivated by the status of RTAs as the primary cause of such injuries and the lack of comprehensive epidemiological data, the researchers aimed to describe API severity and identify associated risk factors using a large-scale trauma registry. The analysis utilized data from the Rhône Registry of Victims of Road Traffic Accidents in France, covering the period from 1996 to 2013. The registry aggregates data from 245 medical and forensic departments, minimizing hospital admission bias. The study population comprised 162,695 victims, of whom 10,165 (6.7%) sustained an API, defined as injury between the diaphragm and pelvic bone. Researchers analyzed demographics, accident characteristics, anatomical lesions, and outcomes using the Abbreviated Injury Scale (AIS) and Injury Severity Score (ISS). Statistical methods included chi-square tests and logistic regression to determine risk factors. Among API victims, the mean age was 32.2 years, with men comprising 62.4% of cases. Car drivers and motorcyclists were the most frequent user types. The mean ISS was 8.7, and the mortality rate for API victims was 5.6%, significantly higher than the 1.1% rate for the general registry population. Soft tissue injuries predominated (54.4%), followed by pelvic bone fractures (2,322 victims) and intra-abdominal organ injuries (2,425 victims), with the spleen, liver, and kidneys being most frequently affected. Seat belt use was a significant protective factor against severe lesions and mortality. Multivariate analysis identified male sex, older age (>46 years), pedestrian or two-wheeler status, nighttime occurrence, rural road location, and fixed obstacles or heavy vehicles as significant risk factors. Conversely, daytime driving in urban areas and seat belt use were protective. The study concludes that while APIs represent a minority of RTA injuries, they carry substantial mortality risk, particularly when associated with severe head or thoracic trauma. The findings highlight that young men and unprotected users (pedestrians, motorcyclists) are at highest risk. The research underscores the protective efficacy of seat belts and suggests that women driving belted cars during the day in urban settings face the lowest risk. The authors note that the incidence of APIs has decreased over the study period, likely due to improved road safety regulations and vehicle engineering.

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• demographic disparities

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• Empirical Findings: observational prevalence, crash risk outcomes