Abstract
Introduction: The severity of injury from motor vehicle crashes (MVCs) depends on complex biomechanical factors, and the bodily features of the injured person account for some of these factors. By assuming that vulnerable road users (VRUs) have limited protection resulting from vehicles and safety equipment, the current study analyzed the characteristics of fat distribution measured by computed tomography (CT) imaging and investigated the existence of a “cushion effect” in VRUs. Materials and Methods: This retrospective study enrolled 592 VRUs involved in MVCs who underwent CT scans. Visceral fat area and subcutaneous fat cross-sectional area were measured and adjusted according to total body area (TBA) and are presented as the visceral fat ratio and the subQ fat ratio (subcutaneous fat ratio). Risk factors for serious abdominal injury (maximum abbreviated injury scale (MAISabd ≥ 3)) resulting from MVCs were determined by univariate and multivariate analysis. Results: MAISabd ≥ 3 was observed in 104 (17.6%) of the patients. The subQ fat ratio at the L4 vertebral level was significantly lower in the MAISabd ≥ 3 group than in the MAISabd < 3 group (24.9 ± 12.0 vs. 28.1 ± 11.9%; p = 0.015). A decreased L4 subQ fat ratio was associated with a higher risk for MAISabd ≥ 3 in multivariate analysis (odds ratio 0.063; 95% CI 0.008–0.509; p = 0.009). Conclusion: The current study supported the “cushion effect” theory, and protection was apparently provided by subcutaneous fat tissue. This concept may further improve vehicle and safety designation in the future.
Highlights
The severity of injury from motor vehicle crashes (MVCs) depends on complex biomechanical factors, and the bodily features of the injured person account for some of these factors
Individuals who were involved in MVCs were included if they were older than 16 years old, had an abdominal multidetector helical computed tomography (MDCT) scan performed primarily for trauma indications, and were admitted to the ward or intensive care unit (ICU)
Between May 2008 and December 2016, 592 vulnerable road users (VRUs) involved in MVCs underwent abdominal CT scans primarily for trauma evaluation
Summary
The severity of injury from motor vehicle crashes (MVCs) depends on complex biomechanical factors, and the bodily features of the injured person account for some of these factors. One of the most popular bodily features, obesity, is characterized as excess fat accumulation It is defined as a BMI ≥ 30 kg/m2 by adopting National Institutes of Health (NIH) and World Health Organization (WHO) guidelines [3,4]. It has been widely discussed in the trauma literature and studies have shown that obesity is associated with a higher risk for post-trauma complications and mortality [5,6,7,8,9,10,11,12,13,14,15,16,17,18,19]
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