■这项研究的目的是描述15至24岁青年的致命行人伤害模式,并使用来自当前加拿大机动车(MV)车队中发生的MVC的法医学死亡调查数据,将其与机动车碰撞(MVC)动力学和行人运动学相关联。
■在系统文献综述的基础上,在伤害数据收集表(IDCF)中整理了MVC-行人伤害。IDCF使用2015年修订的缩写损伤量表(AIS)进行编码。在各个身体区域都注意到最常见的严重伤害的AIS。最大AIS(MAIS)用于定义对身体整体和身体区域的最严重伤害(MAISBR)。这项研究的重点是严重到最大的伤害(AIS3-6),导致死亡的可能性越来越大。IDCF用于从安大略省首席验尸官办公室(OCCO)在多伦多省法医病理学部门(PFPU)进行的验尸数据库中提取碰撞和伤害数据,加拿大,和其他省级设施在2013年至2019年之间。伤害数据与有关MV和MV动力学以及行人运动学的数据相关。该研究获得了西部大学健康科学研究伦理委员会的批准(项目ID:113440;劳森健康研究所批准号。R-19-066)。
■有88名青年,包括54名(61.4%)男性和34名(38.6%)女性。青年行人占所有验尸行人的13.1%(88/670)。汽车(n=25/88,28.4%)是单车碰撞中最常见的车辆类型,但统称为具有高引擎盖边缘的车辆(即,地面和引擎盖边缘之间的距离更大)。前向投影(n=34/88,38.6%)是最常见的行人运动学类型。不管车辆的类型,在大多数病例中,中位MAISBR≥3有累及头部和胸部的趋势.在涉及各种正面碰撞的大多数行人运动学中也看到了类似的趋势。在88个案例中,至少有63人(71.6%)被认为从事冒险行为(例如,道路上的活动)。至少有12人非意外死亡(8起自杀和4起凶杀案)。有些活动可能与减值有关,因为26/63(41.3%)在道路上冒险行为的行人受到损害。毒理学分析显示,超过一半的病例(47/88,53.4%)对可能影响行为的药物检测呈阳性。乙醇是最常见的。31人的血液结果呈阳性。
■在被汽车撞击的行人中观察到致命的头部和胸部创伤。对于那些被高引擎盖边缘车辆撞击的行人,大多数案件都涉及到,头部受伤的致命三合会,胸部,观察到腹部/腹膜后。大多数死亡发生在正面碰撞中,速度超过35公里/小时。
UNASSIGNED: The objective of this study was to describe fatal
pedestrian injury patterns in youth aged 15 to 24 years old and correlate them with motor vehicle collision (MVC) dynamics and
pedestrian kinematics using data from medicolegal death investigations of MVCs occurring in the current Canadian motor vehicle (MV) fleet.
UNASSIGNED: Based on a systematic literature review, MVC-
pedestrian injuries were collated in an injury data collection form (IDCF). The IDCF was coded using the Abbreviated Injury Scale (AIS) 2015 revision. The AIS of the most frequent severe injury was noted for individual body regions. The Maximum AIS (MAIS) was used to define the most severe injury to the body overall and by body regions (MAISBR). This study focused on serious to maximal injuries (AIS 3-6) that had an increasing likelihood of causing death. The IDCF was used to extract collision and injury data from the Office of the Chief Coroner for Ontario (OCCO) database of postmortem examinations done at the Provincial Forensic Pathology Unit (PFPU) in Toronto, Canada, and other provincial facilities between 2013 and 2019. Injury data were correlated with data about the MVs and MV dynamics and pedestrian kinematics.The study was approved by the Western University Health Science Research Ethics Board (Project ID: 113440; Lawson Health Research Institute Approval No. R-19-066).
UNASSIGNED: There were 88 youth, including 54 (61.4%) males and 34 (38.6%) females. Youth pedestrians comprised 13.1% (88/670) of all autopsied pedestrians. Cars (n = 25/88, 28.4%) were the most frequent type of vehicle in single-vehicle impacts, but collectively vehicles with high hood edges (i.e., greater distance between the ground and hood edge) were in the majority. Forward projection (n = 34/88, 38.6%) was the most frequent type of
pedestrian kinematics. Regardless of the type of vehicle, there was a tendency in most cases for the median MAISBR ≥ 3 to involve the head and thorax. A similar trend was seen in most of the
pedestrian kinematics involving the various frontal impacts. Of the 88 cases, at least 63 (71.6%) were known to be engaged in risk-taking behaviors (e.g., activity on roadway). At least 12 deaths were nonaccidental (8 suicides and 4 homicides). Some activities may have been impairment related, because 26/63 (41.3%) pedestrians undertaking risk-taking behavior on the roadway were impaired. Toxicological analyses revealed that over half of the cases (47/88, 53.4%) tested positive for a drug that could have affected behavior. Ethanol was the most common. Thirty-one had positive blood results.
UNASSIGNED: A fatal dyad of head and thorax trauma was observed for pedestrians struck by cars. For those pedestrians hit by vehicles with high hood edges, which were involved in the majority of cases, a fatal triad of injuries to the head, thorax, and abdomen/retroperitoneum was observed. Most deaths occurred from frontal collisions and at speeds more than 35 km/h.