TY  - JOUR
PY  - 2020//
TI  - New cars on the highways: trends in injuries and outcomes following ejection
JO  - Surgery open science
A1  - Manguso, Nicholas
A1  - Barmparas, Galinos
A1  - Dhillon, Navpreet K.
A1  - Ley, Eric J.
A1  - Huang, Raymond
A1  - Melo, Nicolas
A1  - Alban, Rodrigo F.
A1  - Margulies, Daniel R.
SP  - 22
EP  - 26
VL  - 2
IS  - 1
N2  - BACKGROUND: Although ejections from motor vehicles are considered a marker of a significant mechanism and a predictor of severe injuries and mortality, scant recent data exist to validate these outcomes. This study investigates whether ejections increase the mortality risk following a motor vehicle crash using data that reflect the introduction of new vehicles to the streets of a large city in the United States.     Methods: The Trauma and Emergency Medicine Information System of Los Angeles County was queried for patients ≥ 16 years old admitted following a motor vehicle crash between 2002 and 2012. Ejected patients were compared to nonejected. Primary outcome was mortality. A logistic regression model was used to identify predictors of mortality and severe trauma.     Results: A total of 9,742 (6.8%) met inclusion criteria. Of these, 449 (4.6%) were ejected; 368 (82.0%) were passengers and 81 (18.0%) were drivers. The rate of ejection decreased linearly (6.1% in 2002 to 3.4% in 2012). Compared to nonejected patients, ejected patients were more likely to require intensive care unit admission (43.7% vs 22.1%, P < .01), have critical injuries (Injury Severity Score > 25) (24.2% vs 7.3%, P <.01), require emergent surgery (16.3% vs 8.0%, P <.01), and expire in the emergency department (3.6% vs 1.2%, P <.01). Overall mortality was 3.6%: 9.6% for ejected and 3.3% for nonejected patients (P <.01). In a logistic regression model, ejection and extrication both predicted mortality (adjusted odds ratio: 1.83, P <.01 and 1.87, P <.01, respectively). Ejection also predicted critical injuries (Injury Severity Score > 25) with adjusted odds ratio of 2.48 (P <.01).     Conclusion: Ejections following motor vehicle crash have decreased throughout the years; however, they remain a marker of critical injuries and predictive of mortality.<p />  <p>Language: en</p>
LA  - en
SN  - 2589-8450
UR  - http://dx.doi.org/10.1016/j.sopen.2019.08.004
ID  - ref1
ER  -