Why does the passenger always die

Driving experience, crashes and traffic citations of teenage beginning drivers external icon. Accid Anal Prev ;35 3 — J Adolesc Health ;63 5 — Young novice drivers: careless or clueless? Accid Anal Prev ;35 6 — Transp Res Rec ;— Comparison of teen and adult driver crash scenarios in a nationally representative sample of serious crashes external icon. Accid Anal Prev ;— DOT HS Department of Transportation; October The observed effects of teenage passengers on the risky driving behavior of teenage drivers external icon.

Accid Anal Prev ;37 6 — Department of Transportation; June Alcohol-related risk of driver fatalities: an update using data external icon. J Stud Alcohol Drugs ;73 3 — Drugged Driving DrugFacts. Department of Health and Human Services; December Accessed 8 September Published Dec Marijuana Research Report. Compton RP. Department of Transportation; July Neurosci Biobehav Rev ;— SS-8 :1— The duration between the emergency call and hospital arrival was significantly shorter in Period B than in Period A.

There was also significantly lower mortality in Period B than in Period A. Injury severity was then compared between the two periods. There was no significant difference in the ISS of the patients between the two periods Table 2.

The highest AIS score was attained for the chest, followed by the head and lower extremities in both periods. Of the patients in Period A, 7. Patient background characteristics and vital signs at the time of hospital arrival were compared between the fatal and non-fatal groups. Compared with the non-fatal group, the fatal group had a significantly higher mean age and proportion of males, and a significantly lower proportion of front-seat passengers Table 3.

Regarding injury severity, the ISS and AIS of the neck and abdomen were significantly higher in the fatal group than in the non-fatal group Table 4.

Of the patients in Period B, 4. The mean age and proportion of males were significantly higher in the fatal group than the non-fatal group Table 5. Regarding injury severity, the ISS and AIS of the chest, abdomen, and lower extremities were significantly higher in the fatal group than in the non-fatal group Table 6.

To identify variables that were independently associated with fatality, logistic regression analyses were performed based on the univariate results. These variables were included in the logistic regression analysis. Ultimately, male sex OR: 1. Ultimately, male sex OR: 2. Comparing the two study periods, there was a dramatic increase in the mean age of patients with MVC-related injuries from 45 years in Period A to 53 years in Period B.

This trend likely reflects the aging population in Japan, with those aged 65 years or older increasing from As the average life expectancy of Japanese women Comparisons between the two study periods also showed a significant decrease in fatalities from 7. Furthermore, the injury severity in most body regions significantly decreased, and other physiological parameters improved significantly.

These trends are similar to those found in previous retrospective trauma studies 25 , 26 , 27 , 28 , Other studies performed using the same data-bank found that in-hospital mortality decreased over time 27 , Because the number of serious or fatal injuries decreased, the present study found that the GCS score of the patients significantly improved, and that the FAST positivity rate significantly decreased.

It is difficult to explain reductions in in-hospital mortality with any single factor. The decrease in the MVC-related fatality rate over time may have been affected by many factors, such as education, law enforcement, and improvement of prehospital and trauma care including the shortening of the duration between the emergency call and hospital arrival. These educational approaches might contribute to decreased vehicle passenger fatality rates.

A previous study in Japan revealed that helicopter transportation and usage of whole-body computed tomography CT were associated with improved mortality rates for severe trauma patients 32 , 33 , 34 , Japan has the highest number of CT scanners per capita in the world Furthermore, in most emergency departments and critical care centres, high-speed CT scanners are located close to the trauma bay.

Hybrid emergency rooms, which have recently been installed in several facilities, are also associated with increased survival after potentially fatal trauma In the years between the two study periods, laws requiring seatbelt usage in rear seats and strengthened penalties for drunk driving were established. In , the Road Traffic Law was revised so that rear-seat passengers were required to wear a seatbelt, in addition to four-wheeled vehicle drivers and front-seat passengers.

The rates of seatbelt use by rear-seat passengers dramatically increased from 8. Because of improved awareness that seatbelts should be fastened while driving, the respective rates of seatbelt use for drivers, front-seat passengers, and rear-seat passengers increased from When a person is arrested for drunk driving, an in-depth investigation is conducted not only of the driver, but also of the other vehicle passengers or persons who provided the alcohol to the driver.

The revised Road Traffic Law also promotes penalties to fellow passengers or other persons who enabled the drunk driving. After the implementation of this revised Road Traffic Law, the number of traffic collisions caused by drunk driving decreased from 11, in to 3, in We expect further improvements with increased public awareness and decreased social tolerance for alcohol-impaired driving.

Furthermore, improved motor vehicle engineering and safety devices might positively affect in-hospital mortality. The factors independently influencing the occurrence of fatalities in each period were determined by multivariate analyses. However, in —, being a front-seat passenger or having low d-BP, low BT, and high AIS of the neck were not significant independent predictors of fatality.

As mortality rates decreased in the 10 years specified above, the indices related to severe or fatal injuries, such as d-BP, BT, and AIS score of the neck, were not selected. With the introduction of laws on mandating seatbelt use in the rear seat and increased awareness of the importance of seatbelt use, the seatbelt use rate gradually improved, even in the front seats. For front-seat passengers, seatbelt use on general roads increased from Because most people sitting in the front passenger seat are restrained and have airbag protection, being a passenger in the front seat was not significantly associated with fatality in — In both groups, the associations of low GCS and increased age with an increased fatality rate are well understood.

The GCS is well correlated with fatality after head injuries. A systematic review and meta-analysis of trauma patients reported that older patients had higher mortality than younger patients 42 , Older patients have higher mortality and morbidity than younger patients, even in MVCs of equal severity 44 , It has been suggested that the physical vulnerability of older patients leads to a worse prognosis after MVC Injury severity after a MVC is influenced by many age-related physical changes, such as muscle weakness, osteoporosis, and reduction in organ system function.

As the prevalence of seatbelt use increased and airbags became the norm in the driver and front passenger seats, the occurrence of severe chest and head injuries decreased. Seatbelt use prevents severe contact between the chest and abdomen and the vehicle interiors, but the seatbelt itself can apply force that injures the abdominal organs, as the abdomen has no skeletal protection.

With appropriate seatbelt use, the forward movement of the passenger is suppressed during a collision. However, if the seatbelt is not appropriately positioned, there is a higher possibility of abdominal injury caused by the seatbelt 46 , This phenomenon may lead to compression of the abdomen, causing abdominal organ injury during a collision.

Therefore, abdominal injuries may influence on the outcome. A positive FAST result indicates that abdominal injuries are present.

One limitation of this study is that it did not include all injured vehicle passengers in Japan. In addition, almost all certificated trauma educational institutions and many critical care centres participated in this database.

Because the JTDB is the only prospective, nationwide, hospital-based trauma registry, we believe our analyses provided representative results. Second, information on crashes, such as collision details a type of car, collision direction, and velocity , seatbelt use, and airbag deployment was not present in the JTDB registry. Because our study was based on medical data, analyses lacking these details do not have decreased reliability.

However, future studies should examine connections between accident data collected by the police department and medical data based on hospital records in Japan. Minus Related Pages. On This Page. Risk Factors for Child and Teen Passengers. Of the children who died in a crash: Restraint use like car seat, booster seat, or seat belt use varies by age.

Risk Reduction for Every Age. Preventing Motor Vehicle Injuries in Children. The Community Preventive Services Task Force recommends child restraint laws to increase restraint use and decrease injuries and deaths among child passengers, based on strong evidence of effectiveness.

Short-term, high-visibility enforcement of child restraint laws are similar to those used for seat belt use such as Click It or Ticket. Effective programs are short-term, highly visible in the community, and advertised widely in the media. Programs offer print materials, videos, or other instructional aids for parents and caregivers. Additional Resources. Traffic safety facts, data: children. Washington, DC: U. Publication no. Available at Data: Children dot. Atlanta, GA: U. In crashes involving two passenger cars, a lower car safety rating was associated with a 1.

The database includes all motor vehicle crashes that resulted in a death within 30 days and includes 83, vehicles involved in head-on crashes. These ratings, from one to five stars, are based on data from frontal, side barrier and side pole crashes that compare vehicles of similar type, size and weight. The one to five star safety rating system was created in by the National Highway Traffic Safety Administration. Jehle notes that after manufacturers addressed the roll-over problem with SUVs that plagued these vehicles in the s and s, rollover crashes are now much less common in SUVs.