Skip to main content

Advertisement

SpringerLink
Log in

What are the differences in injury patterns of young and elderly traffic accident fatalities considering death on scene and death in hospital?

  • Original Article
  • Published:
International Journal of Legal Medicine Aims and scope Submit manuscript

Abstract

Older traffic participants have higher risks of injury than the population up to 65 years in case of comparable road traffic accidents and further, higher mortality rates at comparable injury severities. Rib fractures as risk factors are currently discussed. However, death on scene is associated with hardly survivable injuries and might not be a matter of neither rib fractures nor age. As 60% of traffic accident fatalities are estimated to die on scene, they are not captured in hospital-based trauma registries and injury patterns remain unknown. Our database comprises 309 road traffic fatalities, autopsied at the Institute of Legal Medicine Munich in 2004 and 2005. Injuries are coded according to Abbreviated Injury Scale, AIS© 2005 update 2008 [1]. Data used for this analysis are age, sex, site of death, site of accident, traffic participation mode, measures of injury severity, and rib fractures. The injury patterns of elderly, aged 65+ years, are compared to the younger ones divided by their site of death. Elderly with death on scene more often show serious thorax injuries and pelvic fractures than the younger. Some hints point towards older fatalities showing less frequently serious abdominal injuries. In hospital, elderly fatalities show lower Injury Severity Scores (ISSs) compared to the younger. The number of rib fractures is significantly higher for the elderly but is not the reason for death. Results show that young and old fatalities have different injury patterns and reveal first hints towards the need to analyze death on scene more in-depth.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. AAAM (2008) Abbreviated Injury Scale 2005, Update 2008. Barrington, IL, USA

  2. United Nations DoEaSA, Population Division (2015) World population prospects: the 2015 revision, World Population 2015 Wallchart

  3. Streit T, Chlond B, Weiß C, Vortisch P (2015) Deutsches Mobilitätspanel (MOP) – Wissenschaftliche Begleitung und Auswertungen Bericht 2013/2014: Alltagsmobilität und Fahrleistung. Karlsruher Institut für Technologie (KIT), Karlsruhe

    Google Scholar 

  4. Clark DE, Chu MK (2002) Increasing importance of the elderly in a trauma system. Am J Emerg Med 20(2):108–111

    Article  PubMed  Google Scholar 

  5. Lustenberger T, Talving P, Schnuriger B, Eberle BM, Keel MJ (2012) Impact of advanced age on outcomes following damage control interventions for trauma. World J Surg 36(1):208–215. doi:10.1007/s00268-011-1321-2

    Article  PubMed  Google Scholar 

  6. Wofford JL, Moran WP, Heuser MD, Schwartz E, Velez R, Mittelmark MB (1995) Emergency medical transport of the elderly: a population-based study. Am J Emerg Med 13(3):297–300. doi:10.1016/0735-6757(95)90203-1

    Article  CAS  PubMed  Google Scholar 

  7. Hannan EL, Waller CH, Farrell LS, Rosati C (2004) Elderly trauma inpatients in New York state: 1994–1998. J Trauma 56(6):1297–1304

    Article  PubMed  Google Scholar 

  8. Maxwell CA (2015) Trauma in the geriatric population. Crit Care Nurs Clin North Am 27(2):183–197. doi:10.1016/j.cnc.2015.02.006

    Article  PubMed  Google Scholar 

  9. Fairfax LM, Hsee L, Civil I (2015) An ageing trauma population: the Auckland experience. New Zealand Med J 128(1414):36–43

    PubMed  Google Scholar 

  10. Morris JA Jr, MacKenzie EJ, Damiano AM, Bass SM (1990a) Mortality in trauma patients: the interaction between host factors and severity. J Trauma 30(12):1476–1482

    Article  PubMed  Google Scholar 

  11. Bergeron E, Lavoie A, Clas D, Moore L, Ratte S, Tetreault S, Lemaire J, Martin M (2003) Elderly trauma patients with rib fractures are at greater risk of death and pneumonia. J Trauma 54(3):478–485. doi:10.1097/01.TA.0000037095.83469.4C

    Article  PubMed  Google Scholar 

  12. McGwin G Jr, Melton SM, May AK, Rue LW (2000) Long-term survival in the elderly after trauma. J Trauma 49(3):470–476

    Article  PubMed  Google Scholar 

  13. Finelli FC, Jonsson J, Champion HR, Morelli S, Fouty WJ (1989) A case control study for major trauma in geriatric patients. J Trauma 29(5):541–548

    Article  CAS  PubMed  Google Scholar 

  14. Carter PM, Flannagan CA, Reed MP, Cunningham RM, Rupp JD (2014) Comparing the effects of age, BMI and gender on severe injury (AIS3+) in motor-vehicle crashes. Accid Anal Prev 72:146–160. doi:10.1016/j.aap.2014.05.024

    Article  PubMed  PubMed Central  Google Scholar 

  15. Ridella SA, Rupp JD, Poland K Age-related differences in AIS3 ± crash injury risk, types, causation and mechanisms. In: International Research Council on the Biomechanics of Injury Conference, Dublin, Ireland, 2012. International Research Council on Biomechanics of Injury, pp 43–60

  16. Gayzik FS, Yu MM, Danelson KA, Slice DE, Stitzel JD (2008) Quantification of age-related shape change of the human rib cage through geometric morphometrics. J Biomech 41(7):1545–1554. doi:10.1016/j.jbiomech.2008.02.006

    Article  PubMed  Google Scholar 

  17. Holcombe SA, Wang SC, Grotberg JB (2016) Modeling female and male rib geometry with logarithmic spirals. J Biomech 49(13):2995–3003. doi:10.1016/j.jbiomech.2016.07.021

    Article  PubMed  Google Scholar 

  18. Kemper AR, McNally C, Kennedy EA, Manoogian SJ, Rath AL, Ng TP, Stitzel JD, Simit EP, Duma SM, Matsuoka F (2005) Material properties of human rib cortical bone from dynamic tension coupon testing. Stapp Car Crash J 49:199–230

    PubMed  Google Scholar 

  19. Kent R, Henary B, Matsuoka F (2005) On the fatal crash experience of older drivers. Ann Proc/ Assoc Adv Automot Med Assoc Adv Automot Med 49:371–391

    Google Scholar 

  20. Kent RW, Lee SH, Darvish K, Wang S, Poster CS, Lange AW (2005) Structural and material changes in the aging thorax and their role in crash protection for older occupants. Stapp Car Crash J 49:231–249

    PubMed  Google Scholar 

  21. Lau A, Oyen ML, Kent RW, Murakami D, Torigaki T (2008) Indentation stiffness of aging human costal cartilage. Acta Biomater 4(1):97–103. doi:10.1016/j.actbio.2007.06.008

    Article  PubMed  Google Scholar 

  22. Wang Y, Cao L, Bai Z, Reed MP, Rupp JD, Hoff CN, Hu J (2016) A parametric ribcage geometry model accounting for variations among the adult population. J Biomech 49(13):2791–2798. doi:10.1016/j.jbiomech.2016.06.020

    Article  PubMed  Google Scholar 

  23. Weaver AA, Schoell SL, Nguyen CM, Lynch SK, Stitzel JD (2014) Morphometric analysis of variation in the sternum with sex and age. J Morphol 275(11):1284–1299. doi:10.1002/jmor.20302

    Article  PubMed  Google Scholar 

  24. Weaver AA, Schoell SL, Stitzel JD (2014) Morphometric analysis of variation in the ribs with age and sex. J Anat 225(2):246–261. doi:10.1111/joa.12203

    Article  PubMed  PubMed Central  Google Scholar 

  25. Holcombe SA, Wang SC, Grotberg JB (2016) The effect of rib shape on stiffness. Stapp Car Crash J 60:11–24

    PubMed  Google Scholar 

  26. Schoell SL, Weaver AA, Vavalle NA, Stitzel JD (2015) Age- and sex-specific thorax finite element model development and simulation. Traffic Injury Prev 16(Suppl 1):S57–S65. doi:10.1080/15389588.2015.1005208

    Article  Google Scholar 

  27. Antona-Makoshi J, Yamamoto Y, Kato R, Kunitomi S, A. K, Dokko Y, Yasuki T, Takamiya T Effect of seatbelt and airbag loads on thoracic injury risk in frontal crashes considering average and small body sizes and age-dependent thoracic fragility. In: IRCOBI (ed) IRCOBI Conference, Malaga (Spain), 14–16 September 2016. IRCOBI Conference Proceedings. International Research Council on the Biomechanics of Injury, pp 904–930

  28. Schoell SL, Weaver AA, Urban JE, Jones DA, Stitzel JD, Hwang E, Reed MP, Rupp JD, Hu J (2015) Development and validation of an older occupant finite element model of a mid-sized male for investigation of age-related injury risk. Stapp Car Crash J 59:359–383

    PubMed  Google Scholar 

  29. Wagner A, Segura R, Mühlbauer R, Fuchs T, Peldschus S, Freßmann D Altersabhängige Anpassung von Menschmodellen für die passive Fahrzeugsicherheit. vol BASt-Bericht F 101. Bundesanstalt für Straßenwesen, Bremen

  30. Wang S Population variability: influence of crash injury outcomes. In: JSAE Annual Congress Forum, Yokohama, Japan, 2013. Proceedings of JSAE Annual Congress Forum

  31. Weaver AA, Nguyen CM, Schoell SL, Maldjian JA, Stitzel JD (2015) Image segmentation and registration algorithm to collect thoracic skeleton semilandmarks for characterization of age and sex-based thoracic morphology variation. Comput Biol Med 67:41–48. doi:10.1016/j.compbiomed.2015.10.004

    Article  PubMed  Google Scholar 

  32. Morris A, Welsh R, Hassan A (2003) Requirements for the crash protection of older vehicle passengers. Ann Proc/Assoc Adv Automot Med Assoc Adv Automot Med 47:165–180

    Google Scholar 

  33. Battle CE, Hutchings H, Evans PA (2012) Risk factors that predict mortality in patients with blunt chest wall trauma: a systematic review and meta-analysis. Injury 43(1):8–17. doi:10.1016/j.injury.2011.01.004

    Article  PubMed  Google Scholar 

  34. Kent R, Woods W, Bostrom O (2008) Fatality risk and the presence of rib fractures. Annals of advances in automotive medicine / Annual Scientific Conference Association for the Advancement of Automotive Medicine Association for the Advancement of Automotive Medicine Scientific Conference 52:73–82

    Google Scholar 

  35. Jones KM, Reed RL 2nd, Luchette FA (2011) The ribs or not the ribs: which influences mortality? Am J Surg 202(5):598–604. doi:10.1016/j.amjsurg.2010.09.029

    Article  PubMed  Google Scholar 

  36. Maxwell CA, Mion LC, Mukherjee K, Dietrich MS, Minnick A, May A, Miller RS (2015) Pre-injury physical frailty and cognitive impairment among geriatric trauma patients determines post-injury functional recovery and survival. J Trauma Acute Care Surg. doi:10.1097/TA.0000000000000929

    PubMed  Google Scholar 

  37. Kovacs EJ (2005) Aging, traumatic injury, and estrogen treatment. Exp Gerontol 40(7):549–555. doi:10.1016/j.exger.2005.04.009

    Article  CAS  PubMed  Google Scholar 

  38. Pfeifer R, Teuben M, Andruszkow H, Barkatali BM, Pape HC (2016) Mortality patterns in patients with multiple trauma: a systematic review of autopsy studies. PLoS One 11(2):e0148844. doi:10.1371/journal.pone.0148844

    Article  PubMed  PubMed Central  Google Scholar 

  39. Chiara O, Scott JD, Cimbanassi S, Marini A, Zoia R, Rodriguez A, Scalea T, Milan Trauma Death Study G (2002) Trauma deaths in an Italian urban area: an audit of pre-hospital and in-hospital trauma care. Injury 33(7):553–562

    Article  PubMed  Google Scholar 

  40. Gunst M, Ghaemmaghami V, Gruszecki A, Urban J, Frankel H, Shafi S (2010) Changing epidemiology of trauma deaths leads to a bimodal distribution. Proc (Baylor Univ Med Cent) 23(4):349–354

    Google Scholar 

  41. Kleber C, Giesecke MT, Tsokos M, Haas NP, Schaser KD, Stefan P, Buschmann CT (2012) Overall distribution of trauma-related deaths in Berlin 2010: advancement or stagnation of German trauma management? World J Surg 36(9):2125–2130. doi:10.1007/s00268-012-1650-9

    Article  PubMed  Google Scholar 

  42. Pang JM, Civil I, Ng A, Adams D, Koelmeyer T (2008) Is the trimodal pattern of death after trauma a dated concept in the twenty-first century? Trauma deaths in Auckland 2004. Injury 39(1):102–106. doi:10.1016/j.injury.2007.05.022

    Article  PubMed  Google Scholar 

  43. Potenza BM, Hoyt DB, Coimbra R, Fortlage D, Holbrook T, Hollingsworth-Fridlund P, Trauma R, Education F (2004) The epidemiology of serious and fatal injury in San Diego County over an 11-year period. J Trauma 56(1):68–75. doi:10.1097/01.TA.0000101490.32972.9F

    Article  PubMed  Google Scholar 

  44. Wood LK, Miller CS, Madura NH, Reed MP, Schneider LW, Klinich KD, Rupp JD (2014) Response and tolerance of female and/or elderly PMHS to lateral impact. Stapp Car Crash J 58:423–463

    PubMed  Google Scholar 

  45. MacLeod JB, Cohn SM, Johnson EW, McKenney MG (2007) Trauma deaths in the first hour: are they all unsalvageable injuries? Am J Surg 193(2):195–199. doi:10.1016/j.amjsurg.2006.09.010

    Article  PubMed  Google Scholar 

  46. Zimmer-Gembeck MJ, Southard PA, Hedges JR, Mullins RJ, Rowland D, Stone JV, Trunkey DD (1995) Triage in an established trauma system. J Trauma 39(5):922–928

    Article  CAS  PubMed  Google Scholar 

  47. Chang DC, Bass RR, Cornwell EE, Mackenzie EJ (2008) Undertriage of elderly trauma patients to state-designated trauma centers. Arch Surg 143(8):776–781 . doi:10.1001/archsurg.143.8.776discussion 782

    Article  PubMed  Google Scholar 

  48. Goodmanson NW, Rosengart MR, Barnato AE, Sperry JL, Peitzman AB, Marshall GT (2012) Defining geriatric trauma: when does age make a difference? Surgery 152(4):668–674 . doi:10.1016/j.surg.2012.08.017discussion 674-665

    Article  PubMed  PubMed Central  Google Scholar 

  49. Hunold KM, Sochor MR, McLean SA, Mosteller KB, Fernandez AR, Platts-Mills TF (2014) Ambulance transport rates after motor vehicle collision for older vs. younger adults: a population-based study. Accid Anal Prev 73:373–379. doi:10.1016/j.aap.2014.09.026

    Article  PubMed  Google Scholar 

  50. Scheetz LJ (2003) Effectiveness of prehospital trauma triage guidelines for the identification of major trauma in elderly motor vehicle crash victims. Journal Emergency Nursing: JEN : Off Publ Emerg Depart Nurses Assoc 29(2):109–115

    Article  Google Scholar 

  51. Scheetz LJ (2011) Trends in the accuracy of older person trauma triage from 2004 to 2008. Prehospital Emerg Care : Off J Natl Assoc EMS Phys Natl Assoc State EMS Dir 15(1):83–87. doi:10.3109/10903127.2010.514088

    Article  Google Scholar 

  52. Leth PM (2015) Computed tomography in forensic medicine. Dan Med J 62(6)

  53. Leth PM, Ibsen M (2010) Abbreviated injury scale scoring in traffic fatalities: comparison of computerized tomography and autopsy. J Trauma 68(6):1413–1416. doi:10.1097/TA.0b013e3181b251b8

    Article  PubMed  Google Scholar 

  54. Buck U, Christe A, Naether S, Ross S, Thali MJ (2009) Virtopsy—noninvasive detection of occult bone lesions in postmortem MRI: additional information for traffic accident reconstruction. Int J Legal Med 123(3):221–226. doi:10.1007/s00414-008-0296-5

    Article  PubMed  Google Scholar 

  55. Borman JB, Aharonson-Daniel L, Savitsky B, Peleg K, Israeli Trauma G (2006) Unilateral flail chest is seldom a lethal injury. Emergency Medicine Journal : EMJ 23(12):903–905. doi:10.1136/emj.2006.037945

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  56. Huber S, Biberthaler P, Delhey P, Trentzsch H, Winter H, van Griensven M, Lefering R, Huber-Wagner S, Trauma Register DGU (2014) Predictors of poor outcomes after significant chest trauma in multiply injured patients: a retrospective analysis from the German trauma registry (trauma register DGU(R)). Scand J Trauma Resusc Emerg Med 22:52. doi:10.1186/s13049-014-0052-4

    Article  PubMed  PubMed Central  Google Scholar 

  57. Barnea Y, Kashtan H, Skornick Y, Werbin N (2002) Isolated rib fractures in elderly patients: mortality and morbidity. Can J Surg J Canadien de chirurgie 45(1):43–46

    Google Scholar 

  58. Battle CE, Evans PA (2015) Predictors of mortality in patients with flail chest: a systematic review. Emergency Medicine Journal : EMJ 32(12):961–965. doi:10.1136/emermed-2015-204939

    Article  PubMed  Google Scholar 

  59. Battle CE, Hutchings H, Evans PA (2013) Expert opinion of the risk factors for morbidity and mortality in blunt chest wall trauma: results of a national postal questionnaire survey of emergency departments in the United Kingdom. Injury 44(1):56–59. doi:10.1016/j.injury.2011.12.012

    Article  PubMed  Google Scholar 

  60. Stawicki SP, Grossman MD, Hoey BA, Miller DL, Reed JF 3rd (2004) Rib fractures in the elderly: a marker of injury severity. J Am Geriatr Soc 52(5):805–808. doi:10.1111/j.1532-5415.2004.52223.x

    Article  PubMed  Google Scholar 

  61. Whitson BA, McGonigal MD, Anderson CP, Dries DJ (2013) Increasing numbers of rib fractures do not worsen outcome: an analysis of the national trauma data bank. Am Surg 79(2):140–150

    PubMed  Google Scholar 

  62. Ankarath S, Giannoudis PV, Barlow I, Bellamy MC, Matthews SJ, Smith RM (2002) Injury patterns associated with mortality following motorcycle crashes. Injury 33(6):473–477

    Article  CAS  PubMed  Google Scholar 

  63. Parreira JG, Martins RK, Slongo J, Perlingeiro JA, Solda SC, Assef JC (2015) Comparative analysis of the frequency and the severity of diagnosed lesions between pedestrians struck by motor vehicles and other blunt trauma mechanisms victims. Rev Col Bras Cir 42(4):253–258. doi:10.1590/0100-69912015004010

    Article  PubMed  Google Scholar 

  64. Demetriades D, Murray J, Martin M, Velmahos G, Salim A, Alo K, Rhee P (2004) Pedestrians injured by automobiles: relationship of age to injury type and severity. J Am Coll Surg 199(3):382–387. doi:10.1016/j.jamcollsurg.2004.03.027

    Article  PubMed  Google Scholar 

  65. Reith G, Lefering R, Wafaisade A, Hensel KO, Paffrath T, Bouillon B, Probst C, TraumaRegister DGU (2015) Injury pattern, outcome and characteristics of severely injured pedestrian. Scand J Trauma Resusc Emerg Med 23:56. doi:10.1186/s13049-015-0137-8

    Article  PubMed  PubMed Central  Google Scholar 

  66. Calosevic S, Lovric Z (2015) Prognostic significance of specific injury patterns in casualties of traffic-related accidents. Injury 46(Suppl 6):S27–S30. doi:10.1016/j.injury.2015.10.049

    Article  PubMed  Google Scholar 

  67. Cordts Filho Rde M, Parreira JG, Perlingeiro JA, Solda SC, Campos T, Assef JC (2011) Pelvic fractures as a marker of injury severity in trauma patients. Rev Col Bras Cir 38(5):310–316

    Article  PubMed  Google Scholar 

  68. Mandal BK, Yadav BN (2014) Pattern and distribution of pedestrian injuries in fatal road traffic accidental cases in Dharan, Nepal. J Nat Sci Biol Med 5(2):320–323. doi:10.4103/0976-9668.136175

    Article  PubMed  PubMed Central  Google Scholar 

  69. Kimbrell BJ, Velmahos GC, Chan LS, Demetriades D (2004) Angiographic embolization for pelvic fractures in older patients. Arch Surg 139(7):728–732 . doi:10.1001/archsurg.139.7.728Discussion 732–723

    Article  PubMed  Google Scholar 

  70. Toth L, King KL, McGrath B, Balogh ZJ (2014) Factors associated with pelvic fracture-related arterial bleeding during trauma resuscitation: a prospective clinical study. J Orthop Trauma 28(9):489–495. doi:10.1097/BOT.0000000000000056

    Article  PubMed  PubMed Central  Google Scholar 

  71. Statistisches-Bundesamt (2016) Verkehrsunfälle Zeitreihen 2015. Verkehrsunfälle Zeitreihen. Statistisches Bundesamt, Wiesbaden

  72. Clark DE, Winchell RJ, Betensky RA (2013) Estimating the effect of emergency care on early survival after traffic crashes. Accid Anal Prev 60:141–147. doi:10.1016/j.aap.2013.08.019

    Article  PubMed  Google Scholar 

  73. Otte D (2000) Charakteristika von Unfällen auf Landstraßen - Analyse aus Erhebungen am Unfallort. BASt-Bericht vol M 122. BASt. doi: ISBN: 978–3–89701-594

  74. Jänsch M, Johannsen, H., Otte, D., Pund, B. (2015) Aspects of age related accident causation factors and implication of safety measures. Paper presented at the ESV-Conference

  75. Utter GH, Victorino GP, Wisner DH (2008) Interhospital transfer occurs more slowly for elderly acute trauma patients. J Emerg Med 35(4):415–420. doi:10.1016/j.jemermed.2007.04.021

    Article  PubMed  Google Scholar 

  76. Osler T, Hales K, Baack B, Bear K, Hsi K, Pathak D, Demarest G (1988) Trauma in the elderly. Am J Surg 156(6):537–543

    Article  CAS  PubMed  Google Scholar 

  77. Chiang WK, Huang ST, Chang WH, Huang MY, Chien DK, Tsai CH (2012) Mortality factors regarding the injury severity score in elderly trauma patients. Int J Gerontol 6:192–195. doi:10.1016/j.ijge.2012.01.016

    Article  Google Scholar 

  78. Werman HA, Erskine T, Caterino J, Riebe JF, Valasek T, Members of the Trauma Committee of the State of Ohio EMSB (2011) Development of statewide geriatric patients trauma triage criteria. Prehospital Disaster Med 26(3):170–179. doi:10.1017/S1049023X11006315

    Article  PubMed  Google Scholar 

  79. Calland JF, Ingraham AM, Martin N, Marshall GT, Schulman CI, Stapleton T, Barraco RD, Eastern Association for the Surgery of T (2012) Evaluation and management of geriatric trauma: an eastern Association for the Surgery of trauma practice management guideline. J Trauma Acute Care Surg 73(5 Suppl 4):S345–S350. doi:10.1097/TA.0b013e318270191f

    Article  PubMed  Google Scholar 

  80. Pape HC, Lefering R, Butcher N, Peitzman A, Leenen L, Marzi I, Lichte P, Josten C, Bouillon B, Schmucker U, Stahel P, Giannoudis P, Balogh Z (2014) The definition of polytrauma revisited: an international consensus process and proposal of the new “Berlin definition”. J Trauma Acute Care Surg 77(5):780–786. doi:10.1097/TA.0000000000000453

    Article  PubMed  Google Scholar 

  81. Daly KE, Thomas PR (1992) Trauma deaths in the south West Thames region. Injury 23(6):393–396

    Article  CAS  PubMed  Google Scholar 

  82. Acosta JA, Yang JC, Winchell RJ, Simons RK, Fortlage DA, Hollingsworth-Fridlund P, Hoyt DB (1998) Lethal injuries and time to death in a level I trauma center. J Am Coll Surg 186(5):528–533

    Article  CAS  PubMed  Google Scholar 

  83. Shackford SR, Mackersie RC, Davis JW, Wolf PL, Hoyt DB (1989) Epidemiology and pathology of traumatic deaths occurring at a level I trauma center in a regionalized system: the importance of secondary brain injury. J Trauma 29(10):1392–1397

    Article  CAS  PubMed  Google Scholar 

  84. Sauaia A, Moore FA, Moore EE, Moser KS, Brennan R, Read RA, Pons PT (1995) Epidemiology of trauma deaths: a reassessment. J Trauma 38(2):185–193

    Article  CAS  PubMed  Google Scholar 

  85. Meislin H, Criss EA, Judkins D, Berger R, Conroy C, Parks B, Spaite DW, Valenzuela TD (1997) Fatal trauma: the modal distribution of time to death is a function of patient demographics and regional resources. J Trauma 43(3):433–440

    Article  CAS  PubMed  Google Scholar 

  86. de Knegt C, Meylaerts SA, Leenen LP (2008) Applicability of the trimodal distribution of trauma deaths in a level I trauma centre in the Netherlands with a population of mainly blunt trauma. Injury 39(9):993–1000. doi:10.1016/j.injury.2008.03.033

    Article  PubMed  Google Scholar 

  87. Lefering R, Paffrath T, Bouamra O, Coats TJ, Woodford M, Jenks T, Wafaisade A, Nienaber U, Lecky F (2012) Epidemiology of in-hospital trauma deaths. Eur J Trauma Emerg Surg: Off Publ Eur Trauma Soc 38(1):3–9. doi:10.1007/s00068-011-0168-4

    Article  CAS  Google Scholar 

  88. Hadfield RJ, Parr MJ, Manara AR (2001) Late deaths in multiple trauma patients receiving intensive care. Resuscitation 49(3):279–281

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Ludwig-Maximilians-University (LMU) Munich, Institute of Legal Medicine, Nussbaumstrasse 26, D-80336, Munich, Germany

    Daniela Heinrich, Anja Wagner, Anja Fischer & Sylvia Schick

  2. Department of Accident and Reconstructive Surgery, Hospital of the RWTH University Aachen, Pauwelsstrasse 30, D-52074, Aachen, Germany

    Christopher Holzmann & Roman Pfeifer

  3. Ludwig-Maximilians-University (LMU) Munich, Head of the Institute of Legal Medicine, Nussbaumstrasse 26, D-80336, Munich, Germany

    Matthias Graw

Authors
  1. Daniela Heinrich
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Christopher Holzmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Anja Wagner
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Anja Fischer
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Roman Pfeifer
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Matthias Graw
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Sylvia Schick
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Daniela Heinrich.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Electronic supplementary material

ESM 1

(PDF 384 kb)

Appendix

Appendix

Table 3 Percentage of road accidents seen in younger and older age groups with death on scene
Full size table
Fig. 5
figure 5

Percentage of males and females showing AIS3+ injury in different body regions, both age groups, death on scene (no visual representation of external body region), and body regions with higher percentages in comparison to the other age group are marked as shaded cells in the tables

Full size image
Fig. 6
figure 6

Percentage of passenger car occupants and pedestrians showing AIS3+ injury in different body regions, both age groups, death on scene (no visual representation of external body region), and body regions with higher percentages in comparison to the other age group are marked as shaded cells in the tables

Full size image
Fig. 7
figure 7

Percentage of rural and urban fatalities showing AIS3+ injury in different body regions, both age groups, death on scene (no visual representation of external body region), and body regions with higher percentages in comparison to the other age group are marked as shaded cells in the tables

Full size image
Table 4 Table 4 Cross tabulation of age group, sex, site of accident, and traffic participation mode for death in hospital
Full size table
Fig. 8
figure 8

Percentage of males and females showing AIS3+ injury in different body regions, both age groups, death in hospital (no visual representation of external body region), and body regions with higher percentages in comparison to the other age group are marked as shaded cells in the tables

Full size image
Fig. 9
figure 9

Percentage of passenger car occupants and pedestrians showing AIS3+ injury in different body regions, both age groups, death in hospital (no visual representation of external body region), and body regions with higher percentages in comparison to the other age group are marked as shaded cells in the tables; low case numbers in elderly passenger car occupants need to be regarded

Full size image
Fig. 10
figure 10

Percentage of rural and urban fatalities showing AIS3+ injury in different body regions, both age groups, death in hospital (no visual representation of external body region), and body regions with higher percentages in comparison to the other age group are marked as shaded cells in the tables

Full size image

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Heinrich, D., Holzmann, C., Wagner, A. et al. What are the differences in injury patterns of young and elderly traffic accident fatalities considering death on scene and death in hospital?. Int J Legal Med 131, 1023–1037 (2017). https://doi.org/10.1007/s00414-017-1531-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00414-017-1531-8

Keywords

Search

Navigation