Background

Previous studies have shown that occupants with obesity are at a greater risk of fatality and serious injury than other occupants in motor vehicle crashes.

Objective

To provide a more complete description of the most frequent injuries and the most frequently injured body regions for occupants with obesity.

Methods

Sampled cases (n = 13,470) representing ~4.7 million adult occupants involved in frontal crashes (between 2000 and 2015) were selected from the U.S. National Automotive Sampling System—Crashworthiness Data System database. A retrospective cohort study was performed to study the effect of BMI on the risk of injury to different body regions and to identify the most frequent injuries to occupants with different BMIs. Lastly, in-depth crash analysis cases from the U.S. Crash Injury Research and Engineering Network (CIREN) database were studied to elucidate the source of the most common injuries to occupants with obesity.

Results

Occupants with obesity experienced a higher risk of upper extremity (4.79 vs 2.92%), lower extremity (8.37 vs 3.23%), and spine (1.53 vs 1.09%) injuries than other occupants. After adjusting for other variables, the risks of spinal, thoracic, and extremities injuries were found to be affected by the BMI class. Seven out of the ten most common injuries sustained by occupants with obesity were lower extremity injuries, and talus fractures were the most common overall. Direct loading through the plantar surface of the foot by the vehicle toe pan was found to be a likely cause of many of those injuries based on CIREN cases.

Conclusions

The injuries of occupants with obesity are different than other occupants which can be attributed to their different interaction with the seat belt and vehicle interior. The findings of this study should be considered for designing restraint systems to protect occupants with obesity in car crashes.

中文翻译：

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正面碰撞中不同BMI类别系安全带乘员的伤害比较。

背景

先前的研究表明，肥胖的乘员在车祸中比其他乘员面临更大的死亡和重伤风险。

客观的

为肥胖乘员提供最常见的伤害和最常受伤的身体部位的更完整描述。

方法

 从美国国家汽车采样系统 - 耐撞性数据系统数据库中选择了代表约 470 万卷入正面碰撞（2000 年至 2015 年）成年乘员的样本案例（n = 13,470）。进行了一项回顾性队列研究，以研究 BMI 对不同身体部位受伤风险的影响，并确定不同 BMI 乘员最常见的受伤情况。最后，对美国碰撞伤害研究与工程网络 (CIREN) 数据库中的深入碰撞分析案例进行了研究，以阐明肥胖乘员最常见的伤害来源。

结果

与其他乘客相比，肥胖乘客上肢（4.79 对 2.92%）、下肢（8.37 对 3.23%）和脊柱（1.53 对 1.09%）受伤的风险更高。在调整其他变量后，发现脊柱、胸部和四肢损伤的风险受 BMI 等级的影响。肥胖乘员所受的十种最常见伤害中有七种是下肢损伤，而距骨骨折是最常见的。根据 CIREN 案例，车辆脚趾板通过足底表面直接加载被发现可能是造成许多此类伤害的原因。

结论

肥胖乘员的伤害与其他乘员不同，这可归因于他们与安全带和车辆内部的不同相互作用。在设计约束系统以保护车祸中肥胖的乘员时，应考虑这项研究的结果。