Motor vehicle crash characteristics and fatal child occupant injuries: An analysis of linked national databases

Background: Motor vehicle crashes are the leading cause of death and disability in the pediatric population. Correlating anatomic injuries with the causative motor vehicle crash characteristics is of paramount importance as a basis for safety design initiatives and injury prevention strategies. Methods: For the period 1999 through 2002, two large, national mortality datasets--Fatality Analysis Reporting System, (FARS) and Multiple Cause-of-Death (MCOD)—were linked at the level of the individual decedent enabling in depth analysis of crash factors associated with the fatal anatomic injuries. Only child occupants (age 0-15 years) were reviewed. Injuries were analyzed based on the recorded ICD-10 codes from MCOD. The distribution of injuries and crash characteristics in this fatally injured population were examined. Results: For the period of review, 6,065 child decedents were recorded. The population was 51.9% male and had a mean age of 8.5 years. The most common body region injured was the head, with 55.9% of decedents sustaining a head injury. Thoracic injuries were noted in 10.2%, and abdominal injuries in 6.5% of the child decedents. Multiple body region injuries were recorded in 25.1% of fatalities. Occupants were most commonly reported as not restrained (56.9%) and rear seated (60.8%). Frontal crashes (41.1%) in passenger cars (62.2%) predominated. Conclusions: The head was the most common body region involved for fatally injured child occupants. These deceased children were most commonly rear seated, unrestrained passengers in frontal crashes. This unique, linked dataset based on national mortality information data may help better understand fatal child occupant injuries.