Vieillissement et gravité des atteintes lésionnelles des victimes d’accident de la circulation routière

Abstract

This study uses the road traffic accident casualty register for the Rhône Département to investigate how the risk of severe or fatal injury varies according to age and to describe the injuries that explain the severity. Two groups of road users are investigated, car occupants and pedestrians. A NISS score of nine or over is taken to indicate a severe injury. Data analysis reveals that, for both groups, the risk of severe or fatal injury increases with age. The nature and location of the injuries depend on the age and sex of the victims. With regard to severe injuries, elderly female pedestrians are susceptible to fractures of the femur (and the femoral neck) and all parts of the upper limbs. Elderly male pedestrians are mainly exposed to fractures of the femoral neck. The greater vulnerability of severely injured elderly drivers results in thoracic injuries, which are partly explained by seat–belt wearing. The main cause of death, for pedestrians of all ages and young drivers is severe head injuries. Car occupants over the age of fifty more frequently suffer from severe thoracic injuries. These findings should not, however, be allowed to conceal the differences observed in the general population for the two severity criteria we have analyzed (severe injury or death). Mortality (in relation to the general population) is highest for young car occupants, while lethality (the fatality rate amongst those injured) is highest among the elderly. For pedestrians, both mortality and lethality increase with age. These findings are also applicable to the risk of severe injury. They justify the continuation of passive safety research in order to develop protection systems that are appropriate for the characteristics of car occupants. Furthermore, they should help to increase everybody’s awareness of the vulnerability of pedestrians and stimulate the introduction of preventive measures, particularly for seniors.