Original CommunicationCardiac injuries in car occupants in fatal motor vehicle collisions – An autopsy-based study
Introduction
More than a million people are killed in road accidents every year, making injuries sustained in motor vehicle collisions one of the leading causes of death worldwide.24, 29 Blunt cardiac injuries are a major factor influencing the prognosis of motor vehicle crash victims, and the presence and nature of cardiac injuries thus has major therapeutic implications. The diagnosis and therapy of blunt cardiac trauma has been addressed in clinical studies, but the management of blunt cardiac trauma patients is somewhat controversial, especially as the diagnosis of “minor”, but still potentially fatal, cardiac trauma remains difficult.10, 15, 19 An earlier autopsy study suggested that in unrestrained drivers, the presence of 8 or more rib fractures predicts cardiac and thoracic aortic injuries in frontal collisions.11
In order to assess the frequency and pattern, and to identify predictive factors of cardiac injuries in motor vehicle occupants, we reviewed the autopsy reports of 380 such fatalities subjected to medico-legal autopsy in Adelaide, Australia, and Hamburg, Germany, between 2000 and 2005.
Section snippets
Methods
We retrospectively analysed the reports of 380 motor vehicle occupant fatalities resulting from vehicle crashes where the victims were subjected to medico-legal autopsy in Adelaide, Australia, and Hamburg, Germany, from 2000 to 2005. The cases were identified by an electronic database search using the words “crash”, “accident”, “motor vehicle”, “car”, “driver” and “passenger”. Victims who were involved in crashes resulting from an underlying organic disease, such as a myocardial infarction,
Study population
Of the 380 motor vehicle occupant fatalities included in the study, 80 (21.1%) cases presented with cardiac injuries. The mean age of all victims was 41.5 years (41.2 years in the cardiac injury group) with an age range of 19 months to 86 years. 77.9% of the cases were males. The mean age was similar in males (40.8 years, age range 19 months to 81 years) and females (42.2 years, age range 14–86 years).
Police data
Frontal (37 cases) and lateral (33 cases) collisions accounted for the majority of cases in
Discussion
The present autopsy-based study of cardiac injuries in motor vehicle occupants following collisions demonstrates that blunt cardiac injury is a frequent event.
It has been shown repeatedly and is now generally accepted that the proper use of seat belts reduces the risk of thoracic injury in motor vehicle collisions, and airbags have also been demonstrated to lower the risk of thoracic injuries.5, 7, 13, 16, 20 Others, however, have found that in restrained drivers, the risk of thoracic injury
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