Motor vehicle collisions (MVCs), particularly those associated with entrapment, are a common cause of major trauma. Current extrication methods are focused on spinal movement minimisation and mitigation, but for many patients self-extrication may be an appropriate alternative. Older drivers and passengers are increasingly injured in MVCs and may be at an increased risk of entrapment and its deleterious effects. The aim of this study is to describe the injuries, trapped status, outcomes, and potential for self-extrication for patients following an MVC across a range of age groups. This is a retrospective study using the Trauma Audit and Research Network (TARN) database. Patients were included if they were admitted to an English hospital following an MVC from 2012 to 2019. Patients were excluded when their outcomes were not known or if they were secondary transfers. Simple descriptive analysis was used across the age groups: 16–59, 60–69, 70–79 and 80+ years. Logistic regression was performed to develop a model with known confounders, considering the odds of death by age group, and examining any interaction between age and trapped status with mortality. 70,027 patients met the inclusion criteria. Older patients were more likely to be trapped and to die following an MVC (p < 0.0001). Head, abdominal and limb injuries were more common in the young with thoracic and spinal injuries being more common in older patients (all p < 0.0001). No statistical difference was found between the age groups in relation to ability to self-extricate. After adjustment for confounders, the 80 + age group were more likely to die if they were trapped; adjusted OR trapped 30.2 (19.8–46), not trapped 24.2 (20.1–29.2). Patients over the age of 80 are more likely to die when trapped following an MVC. Self-extrication should be considered the primary route of egress for patients of all ages unless it is clearly impracticable or unachievable. For those patients who cannot self-extricate, a minimally invasive extrication approach should be employed to minimise entrapment time.

中文翻译：

---

受困、受伤、结果和自救的可能性是否随年龄而变化？对英国创伤登记处 (TARN) 的预先指定分析

机动车辆碰撞 (MVC)，尤其是与被困相关的碰撞，是造成重大创伤的常见原因。目前的解救方法主要集中在脊柱运动的最小化和缓解上，但对于许多患者来说，自我解救可能是一种合适的选择。年长的司机和乘客在 MVC 中受伤的人数越来越多，并且可能会增加被困的风险及其有害影响。本研究的目的是描述不同年龄组的 MVC 后患者的损伤、被困状态、结果和自救的可能性。这是一项使用创伤审计和研究网络 (TARN) 数据库的回顾性研究。如果患者在 2012 年至 2019 年接受 MVC 后入住英国医院，则被纳入研究。当患者的结果未知或如果他们是二次转移时，他们被排除在外。对年龄组进行了简单的描述性分析：16-59、60-69、70-79 和 80 岁以上。进行逻辑回归以开发具有已知混杂因素的模型，考虑按年龄组划分的死亡几率，并检查年龄和被困状态与死亡率之间的任何相互作用。70,027 名患者符合纳入标准。老年患者更有可能在 MVC 后被困并死亡 (p < 0.0001)。头部、腹部和四肢损伤在年轻人中更为常见，而胸部和脊柱损伤在老年患者中更为常见（所有 p < 0.0001）。在自救能力方面，年龄组之间没有发现统计学差异。调整混杂因素后，80 岁以上的年龄组如果被困，更有可能死亡；调整或被困 30.2 (19.8–46)，未被困 24.2 (20.1–29.2)。80 岁以上的患者在 MVC 后被困时更有可能死亡。自救应被视为所有年龄段患者的主要逃生途径，除非它明显不切实际或无法实现。对于不能自救的患者，应采用微创自救方法，尽量减少卡压时间。