The current study will attempt to elucidate whether frailty has a role in motor vehicle crash injury causation. The association between frailty and injury was studied among Crash Injury Research Engineering Network (CIREN) cases. The baseline “physical functioning” (PF) score of the SF-36 was used as a marker of frailty (i.e., PF score <75). Frailty associations with ISS and occupant, vehicular and crash factors were explored. Frailty association with delta V was analysed among injured (i.e., brain, rib, or femur) belted occupants in frontal crashes to establish whether frailty confers a different risk of each particular injury. Frailty occurred in 13.7 % of the cohort (n=1,747). Median (q1-q3) ISS was 14.0 (10–22) among the frail and 17.0 (10–24) among the non frail (p=0.40). Frailty was significantly associated with advanced age, male gender, the presence of co-morbidities, extreme BMIs, frontal and near-side crashes and delta V < 45 km/h. Seat belt use and ISS<16 were not associated with frailty. Multiple linear regressions, adjusting for age, gender and BMI revealed a negative association between frailty and log delta V (coefficient ?0.188, p=0.04) among those with rib fractures but not among those with brain injuries or femur fractures. PF score, a marker of frailty, is associated with similar ISS and lower delta V and is independently linked to lower delta V thresholds for some injuries (i.e. rib fractures) but not for others (i.e. brain injuries and femur fractures). These associations suggest a potential role of frailty in injury causation. (Author/publisher)
Samenvatting