Injury pattern in lethal motorbikes-pedestrian collisions, in the area of Barcelona, Spain

https://doi.org/10.1016/j.jflm.2016.07.009Get rights and content

Highlights

  • The most important cause of death for the pedestrians involved in motorbike collisions was TBI.

  • The most frequent sustained injuries were subarachnoid hemorrhage in 71.4%.

  • Higher Pelvic injury is observed in this study compared to passenger car collisions.

Abstract

Introduction

There are several studies about M1 type vehicle-pedestrian collision injury pattern, and based on them, there has been several changes in automobiles for pedestrian protection. However, the lack of sufficient studies about injury pattern in motorbikes-pedestrian collisions leads to a lack of optimization design of these vehicles. The objective of this research is to study the injury pattern of pedestrians involved in collisions with motorized two-wheeled vehicles.

Methods

A retrospective descriptive study of pedestrian's deaths after collisions with motorcycles in an urban area, like Barcelona was performed. The cases were collected from the Forensic Pathology Service database of the Institute of Legal Medicine of Catalonia. The selected cases were categorized as pedestrian-motorcycle collision, between January 1st, 2005 and December 31st, 2014. Data were collected from the autopsy, medical, and police report. The collected information was then analyzed using Microsoft Excel statistical functions.

Results

Traumatic Brain Injury is the main cause of death in pedestrian hit by motorized two-wheeled vehicles (62.85%). The most frequent injury was the subarachnoid hemorrhage, in 71.4% of cases, followed by cerebral contusions and skull base fractures (65.7%). By contrast, pelvic fractures and tibia fractures only appeared in 28.6%.

Conclusions

The study characterizes the injury pattern of pedestrians involved in a collision with motorized two-wheeled vehicles in an urban area, like Barcelona, which has been found to be different from other vehicle-pedestrian collisions, with a higher incidence of brain injuries and minor frequency of lower extremities fractures in pelvis, tibia and fibula.

Introduction

Traffic accidents, including pedestrian-vehicle collisions, are one of the leading causes of death in developed and developing countries. In 2005 in the United States more than 64,000 of the injured people were pedestrians,1 in Germany in 2008, a total of 695 pedestrians were killed and 33.733 were injured.2 The magnitude of the epidemiologic problem takes even more importance in developing countries, for instance in Ghana 60% of people who died by traffic accidents were pedestrians.3 Therefore, there are many initiatives undertaken by different institutions to reduce the number of accidents and fatalities involving pedestrians, as well as the severity of the sustained injuries.

In recent years there has been greater awareness in relation to the so-called vulnerable users on the road such as pedestrians, cyclists and two-wheeled motor users.4, 5 The highest incidence of motorcycle accidents are related to the characteristics of the vehicle, such as its high maneuverability or its great power in relation to its weight. Moreover, its high morbidity and mortality are due to both the driver and the passenger due to the lack of body structure and protection in comparison to other vehicles. Additionally, it particularly affects young people, leading to a great loss of labor capacity or loss in life years.6

On the other hand, in relation to pedestrians, awareness is such that the European Union Directive 2003/102/EC of the European Parliament and of the Council from November 17th, 2003 related to the protection of pedestrians, amending Directive 70/156/EEC, has forced the automotive industry to redesign M1 vehicles for their design to be more friendly for the pedestrians in case of collision. This regulation is not intended to avoid any injury in case of impact, but to minimize its consequences in order to prevent unnecessary injuries. These adopted measures consist, inter alia, to increase the distance between the hood and the rigid structures, to include collapsible structures designed to absorb energy, to incorporate energy absorbing elements between the pedestrian and rigid structures, reducing the potential of area being impacted, etc.7

Most of the current research has been done on type M1 vehicles. Currently there is a lack of knowledge of the injury patterns in other vehicles such as motorcycles. Is there any difference between M1 injury pattern and motor vehicles with two wheels? Is vulnerability affected by geometric factors, stiffness, size, speed, momentum or a combination of all of them?.8 It would seem common sense that stiffness, speed and mass are against the pedestrian, since in this type of collision pedestrians are injured in different levels of severity or, as we will discuss in this research, even death. However, there is not legislation for the design of motorcycles to try to minimize the consequences of a pedestrian impact.

It is not difficult to find literature on motorcycle accidents and injuries sustained by the drivers, or about the pedestrian injury pattern from vehicle collisions,1, 2 however it is challenging to find literature relative to collisions of pedestrians struck by motorcycles. The aim of this study is to describe the injury pattern of pedestrians who have been struck by motorcycles that resulted on death, in urban areas.

Section snippets

Method

A retrospective descriptive study of pedestrian's deaths after collisions with motorcycles in an urban area like Barcelona was conducted between January 1st, 2005 and December 31st, 2014. The cases were collected from the entire registry of the Forensic Pathology Service database of the Institute of Legal Medicine of Catalonia. The inclusion criterion was to be categorized as pedestrian-motorcycle collision. The data were collected from the autopsy report and complemented with the medical and

Results

A total of 35 pedestrian fatal cases were collected, 18 men and 17 women, with an average age of 67.4 ± 22.7 years for women and 72.3 ± 15.2 years for men.

From the 35 pedestrians, 91.4% (n = 32) of the cases received hospital treatment while the other three people died in the crash site. Those who received hospital care, 80% died the same day of the accident or the next day; and those who survived beyond two days had an average hospital stay of 4 days. The results are presented in Table 1.

The

Discussion

Although Legal Medicine9 has always considered the car pedestrian collision as typical or atypical, according to four phases (crashing, dropping, dragging and crushing), recent literature has indicated that this classification is not completely satisfactory. In practice, researchers consider an important distinction between first and second impacts10: the first impact is the one against the vehicle, and the second impact is the one against the floor.

Both classifications are based on injuries

Conclusions

A retrospective descriptive study of pedestrian's deaths after collisions with motorcycles in an urban area like Barcelona was conducted; the conclusion of this investigation shows the injury pattern of fatal motorcycle-pedestrian collisions. The main injuries sustained by the pedestrian were located in head, thorax and lower extremities. In the case of the head injuries, the subarachnoid hemorrhage in 71.4% of cases, cerebral contusions and skull base fractures (65.7%) and subdural hematomas

Contributions

M. Carmen Rebollo-Soria: Data collection, article preparation, initial data analysis. Carlos. Arregui-Dalmases: article conception, study design. David Sánchez-Molina: Data analysis, literature review, discussion section. Juan Velázquez-Ameijide: Acquisition of data, successive revisions of the manuscript. Ignasi Galtés: Acquisition of data, revising the article in critically for important intellectual content, final approval of the version to be published.

Conflict of interest

The authors report no conflict of interest in this research.

Acknowledgements

The authors would like to thank Luis Pedro Cobos for his efforts in editing the paper.

References (15)

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