Bedingt durch ihre Definition - mindestens 24-stündiger Klinikaufenthalt - umfasst die Kategorie der Schwerverletzten in der amtlichen Verkehrsunfallstatistik eine große Breite tatsächlicher Verletzungsschweregrade. Durch das hohe persönliche Leid sowie die bedeutsamen volkswirtschaftlichen Kosten sind innerhalb dieser Gruppe die Schwerstverletzten von besonderem Interesse. Es werden drei Studien der Bundesanstalt für Straßenwesen (BASt) vorgestellt, in denen auf Grundlage verschiedener Datenquellen Verletzungsmuster und Verletzungsschwere in Zusammenhang mit Parametern des Unfallgeschehens gebracht wurden. Zusammengefasst zeigt sich, dass (a) die Zahl der Schwerstverletzten sich in den letzten Jahren nicht in gleichem Maße reduziert hat, wie die Zahlen Schwerverletzter und Getöteter; (b) sich über verschiedene Datenquellen (GIDAS, TraumaRegister DGU, Rettungsdienst, Polizei) ähnliche Verletzungsmuster in Abhängigkeit der Verkehrsteilnahme zeigen; (c) durch die Verbindung von medizinischen Daten des TraumaRegisters mit Daten der Polizei gute Voraussetzungen für eine umfangreiche Erfassung Schwerstverletzter in Deutschland geschaffen werden könnten.
This study is aimed to investigate the correlations of impact conditions and dynamic responses with the injuries and injury severity of child pedestrians by accident reconstruction. For this purpose, the pedestrian accident cases were selected from Sweden and Germany with detailed information about injuries, accident cars, and accident environment. The selected accident cases were reconstructed using mathematical models of pedestrian and passenger car. The pedestrian models were generated based on the height, weight, and age of the pedestrian involved in accidents. The car models were built up based on the corresponding accident car. The impact speeds in simulations were defined based on the reported data. The calculated physical quantities were analyzed to find the correlation with injury outcomes registered in the accident database. The reconstruction approaches are discussed in terms of data collection, estimating vehicle impact speeds, pedestrian moving speeds and initial posture, secondary ground impact, validity of the mathematical models, as well as impact biomechanics.
Bicyclists are minimally or unprotected road users. Their vulnerability results in a high injury risk despite their relatively low own speed. However, the actual injury situation of bicyclists has not been investigated very well so far. The purpose of this study was to analyze the actual injury situation of bicyclists in Germany to create a basis for effective preventive measures. Technical and medical data were prospectively collected shortly after the accident at the accident scenes and medical institutions providing care for the injured. Data of injured bicyclists from 1985 to 2003 were analyzed for the following parameters: collision opponent, collision type, collision speed (km/h), Abbreviated Injury Scale (AIS), Maximum AIS (MAIS), incidence of polytrauma (Injury Severity Score >16), incidence of death (death before end of first hospital stay). 4,264 injured bicyclists were included. 55% were male and 45% female. The age was grouped to preschool age in 0.9%, 6 to 12 years in 10.8%, 13 to 17 years in 10.4%, 18 to 64 years in 64.7%, and over 64 years in 13.2%. The MAIS was 1 in 78.8%, 2 in 17.0%, 3 in 3.0%, 4 in 0.6%, 5 in 0.4%, and 6 in 0.2%. The incidence of polytrauma was 0.9%, and the incidence of death was 0.5%. The incidence of injuries to different body regions was as follows: head, 47.8%; neck, 5.2%, thorax, 21%; upper extremities, 46.3%; abdomen, 5.8%; pelvis, 11.5%, lower extremities, 62.1%. The accident location was urban in 95.2%, and rural in 4.8%. The accidents happened during daylight in 82.4%, during night in 12.2%, and during dawn/dusk in 5.3%. The road situation was as follows: straight, 27.3%; bend, 3.0%; junction, 32.0%; crossing, 26.4%; gate, 5.9%; others, 5.4%. The collision opponents were cars in 65.8%, trucks in 7.2%, bicycles in 7.4%, standing objects in 8.8%, multiple objects in 4.3%, and others in 6.5%. The collision speed was grouped <31 in 77.9%, 31-50 in 4.9%, 51-70 in 3.7%, and >70 in 1.5%. The helmet use rate was 1.5%. 68% of the registered head injuries were located in the effective helmet protection area. In bicyclists, head and extremities are at high risk for injuries. The helmet use rate is unsatisfactorily low. Remarkably, two thirds of the head injuries could have been prevented by helmets. Accidents are concentrated to crossings, junctions and gates. A significant lower mean injury severity was observed in victims using separate bicycle lanes. These results do strongly support the extension or addition of bicycle lanes and their consequent use. However, the lanes are frequently interrupted at crossings and junctions. This emphasizes also the important endangering of bicyclists coming from crossings, junctions and gates, i.e. all situations in which contact of bicyclists to motorized vehicles is possible. Redesigning junctions and bicycle traffic lanes to minimize the possibility of this dangerous contact would be preventive measures. A more consequent helmet use and use and an extension of bicycle paths for a better separation of bicyclists and motorized vehicle would be simple but very effective preventive measures.
The incidence and treatment of sternal fractures among traffic accidents are of increasing importance to ensure best possible outcomes. Analysis of technical indicators of the collision, preclinical and clinical data of patients with sterna fractures from 1985-2004 among 42,055 injured patients were assessed by an Accident Research Unit. Two time groups were categorized: 1985-1994 (A) vs. 1995-2004 (B). 267/42,055 patients (0.64%) suffered a sterna fracture. Regarding the vehicle type, the majority occurred after car accidents in 0.81% (251/31,183 pts), followed by 0.19% (5/2,633pts) driving motorbike, and 0.11% (4/3,258pts) driving a truck. 91% wore a safety belt. Only 13% of all passengers suffering a sternal fracture had an airbag on board (33/255 car/trucks), with an airbag malfunction in 18%. The steering column was deformed in 39%, the steering wheel in 36%. Cars in the recent years were significantly older (7.67-±5 years (B) vs. 5.88-±5 years (A), p=0.003). Cervical spine injuries are frequent (23% vs. 22%), followed by multiple rib fractures (14% vs. 12%) and lung injuries (12% vs. 11%). We found 9/146 (6%) and 3/121 patients (3%) with heart contusion among the 267 sternal fractures. MAIS was 2.56-±1.3 vs. 2.62-±1.3 (A vs. B, p=0.349). 18% of patients were polytraumatized, with 11.2% dying at the scene, 2.3% in the hospital. Sternal fractures occur most often in old cars to seat-belted drivers often without any airbag. Severe multiple rib fractures and lung contusion are concomitant injuries in more than 10% each indicating the severity of the crash. Over a twentyyear period, the injury severity encountered was not different with 18% polytrauma patients suffering sternal fractures.
The bicyclist accidents were analyzed to get better understanding of the occurrences and frequency of the accidents, injury distributions, as well as correlation of injury severity/outcomes with engineering and human factors in two different countries of China and Germany. The accident cases that occurred from 2001 to 2006 were collected from IVAC database in Changsha and GIDAS database in Hannover. Based on specified sampling criteria, 1,570 bicyclist cases were selected from IVAC database in Changsha, and 1806 cases were collected from Hannover, documented in GIDAS database. Statistical analyses were carried out by using these selected data. The results from the statistical analysis are presented and discussed in this study.
To elucidate the risk of pedestrians, bicycle and motorbike users, data of two accident research units from 1999 to 2014 were analysed in regard to demographic data, collision details, preclinical and clinical data using SPSS. 14.295 injured vulnerable road users were included. 92 out of 3610 pedestrians ("P", 2.5%), 90 out of 8307 bicyclists ("B", 1.1%) and 115 out of 4094 motorcycle users ("M", 2.8%) were diagnosed with spinal fractures. Thoracic fractures were most frequent ahead of lumbar and cervical fractures. Car collisions were most frequent mechanism (68, 62 and 36%). MAIS was 3.8, 2.8 and 3.2 for P, B and A with ISS 32, 16 and 23. AIS-head was 2.2, 1.3 and 1.5). Vulnerable road users are at significant risk for spine fractures. These are often associated with severe additional injuries, e.g. the head and a very high overall trauma severity (polytrauma).
Introduction: Spine injuries pose a considerable risk to life and quality of life. The total number of road deaths in developed countries has markedly decreased, e.g. in Germany from over 20000 in 1970 to less than 4000 in 2010, but little is known how this is reflected in the burden of spine fractures of motor vehicle users. In this study, we aimed to show the actual incidence of spine injuries among drivers and front passengers and elucidate possible dependencies between crash mechanisms and types of injuries.
While cyclists and pedestrians are known to be at significant risk for severe injuries when exposed to road traffic accidents (RTAs) involving trucks, little is known about RTA injury risk for truck drivers. The objective of this study is to analyze the injury severity in truck drivers following RTAs. Between 1999 and 2008 the Hannover Medical School Accident Research Unit prospectively documented 43,000 RTAs involving 582 trucks. Injury severity including the abbreviated injury scale (AIS) and the maximum abbreviated injury scale (MAIS) were analyzed. Technical parameters (e.g. delta-v, direction of impact), the location of accident, and its dependency on the road type were also taken into consideration. The results show that the safety of truck drivers is assured by their vehicles, the consequence being that the risk of becoming injured is likely to be low. However, the legs especially are at high risk for severe injuries during RTAs. This probability increases in the instance of a collision with another truck. Nevertheless, in RTAs involving trucks and regular passenger vehicles, the other party is in higher risk of injury.
This paper describes the methodology of In-Depth Investigation in Germany on the example of GIDAS (German In-Depth Accident Study). Since 1999 in Germany a joint project between FAT (Forschungsvereinigung Automobiltechnik or Automotive Industry Research Association) and BASt (Bundesanstalt für Straßenwesen or the Federal Road Research Institute) is being carried out in Hannover and Dresden. The methodology of this project is based on a statistically orientated procedure of data sampling (sampling plan, weighting factors). The paper describes the possibilities of such in-depth investigation on the results of the offered title. The accident cases were collected randomly within GIDAS at Hannover. There are more cases existing from previous investigation started in 1985 under the same methodology. The portion of rollovers can be established at 3.7% of all accidents with casualties in the year 2000. For the study 434 cases of car accidents with rollovers are used for a detail comprehensive analysis. The accidents happened in the years 1994 to 2000 in the Hannover area. The injury distribution will report about 741 occupants with rollover accident event. The presented paper will give an overview of the accident situations following in rollover movements of cars. The distributions of injury frequencies, injury severity AIS for the whole body and for the body regions of occupants will be presented and compared to technical details like the impact speed and the deformation pattern. The speed of the car was determined at the point of rollover and on the point of accident initiency. The characteristics of the kinematics followed in a rollover movement are analyzed and the major defined types of rollover will be shown in the paper. The paper will describe the possibilities of In-Depth Investigation methods for the approach of finding countermeasures on the example of car accidents with rollover and explaining the biomechanics of injuries in rollover movements.
Der Vergleich der Ergebnisse aus drei von der Bundesanstalt für Straßenwesen (BASt) durchgeführten Studien ergab, dass keiner der bisher gewählten Ansätze optimal erscheint, um als Grundlage für eine langfristige Untersuchungsreihe zu schwerstverletzten Unfallopfern zu dienen. Dagegen verspricht die Verknüpfung der Daten des Traumaregisters der Deutschen Gesellschaft für Unfallchirurgie mit polizeilichen Unfalldaten einen Fortschritt. Somit könnten die Primärdaten zweier bereits etablierter Dokumentationssysteme für die künftige Untersuchung der Schwer(st)verletztenproblematik effizient genutzt werden. Zu einem ähnlichen Ergebnis kommt eine aktuelle Studie der Rheinisch-Westfälischen Hochschule Aachen und der Universitätsklinik Aachen aus dem Jahr 2009. Hierdurch wurde der viel versprechende Erkenntnisgewinn zur Verletzungsschwere und Verletzungsmustern belegt, der durch eine Zusammenführung der Daten der laut amtlicher Unfallstatistik Schwerstverletzten mit denjenigen der nach medizinischen Krankenakten ermittelten schweren Unfälle bestätigt.