Effect of Maryland's 2011 Alcohol Sales Tax Increase on Alcohol-Positive Driving.

Introduction: The 2011 Maryland alcohol sales tax increase from 6% to 9% provided an opportunity to evaluate the impact on rates of alcohol-positive drivers involved in injury crashes.

Methods: Maryland police crash reports from 2001 to 2013 were analyzed using an interrupted time series design and a multivariable analysis employing generalized estimating equations models with a negative binomial distribution. Data were analyzed in 2014-2015.

On equal footing: Trends in ankle/foot injuries for men vs. women.

Objectives: The objective of the current study was to examine trends in ankle/foot (A/F) injuries during the period 2001-2014, in order to determine whether the incidence of these injuries has changed and whether a previously identified difference in risk by gender still existed. In addition, other driver and crash-related risk factors were examined separately for men and women.

Methods: Passenger vehicle drivers aged 16+ were identified from NASS-CDS; weighted data were analyzed for model years 2001-2014.

S-100β does not predict outcome after mild traumatic brain injury.

Objective: To determine the usefulness of S-100β, a marker for central nervous system damage, in the prediction of long-term outcomes after mild traumatic brain injury (MTBI) Hypothesis: Mid- and long-term outcomes of MTBI (i.e. 3, 6 and 12 months post-injury and return-to-work or school (RTWS)) may be predicted based on pre-injury and injury factors as well as S-100β.

Declining statewide trends in motor vehicle crashes and injury-related hospital admissions.

Numbers of crashes, rates of police-reported injury severity, and hospital admission rates were calculated for the ten year period between 2001 and 2010 in Maryland. Comparisons were made for two 5-year periods of 2001-2005 and 2006-2010. Crash characteristics remained similar for the two five-year periods, but there was a significant increase in occupant age.

Aortic injuries in newer vehicles.

The occurrence of AI was studied in relation to vehicle model year (MY) among front seat vehicular occupants, age≥16 in vehicles MY≥1994, entered in the National Automotive Sampling System Crashworthiness Data System between 1997 and 2010 to determine whether newer vehicles, due to their crashworthiness improvements, are linked to a lower risk of aortic injuries (AI). MY was categorized as 1994-1997, 1998-2004, or 2005-2010 reflecting the introduction of newer occupant protection technology. Logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals for the association between AI and MY independent of possible confounders.

Causation and outcomes of diaphragmatic injuries in vehicular crashes.

Background: This study aimed to identify vehicular and crash factors associated with diaphragmatic injuries (DIs).

Methods: DI presence was analyzed among Crash Injury Research and Engineering Network vehicular occupants (age ≥ 16 years) in relation to occupant and crash factors. Contact points (i.

Degree of urbanization and mortality from motor vehicular crashes.

Purpose: : The purpose of this study is to establish whether motor vehicular crash (MVC) case fatality varies across different urbanization levels in the USA using a representative sample of crashes.

Methods: : Odds ratios (ORs) and 95% confidence intervals (CIs) for the association between urbanization level [i.e.

Frailty and injury causation.

Purpose: : The current study will attempt to elucidate whether frailty has a role in motor vehicle crash injury causation.

Methods: : The association between frailty and injury was studied among Crash Injury Research Engineering Network (CIREN) cases. The baseline "physical functioning" (PF) score of the SF-36 was used as a marker of frailty (i.

Improving trauma triage using basic crash scene data.

Objective: to analyze the occurrence of severe injuries and deaths among crash victims transported to hospitals in relation to occupant and scene characteristics, including on-scene patient mobility, and their potential use in triaging patients to the appropriate level of care.

Methods: the occurrence of death and ISS>15 were studied in relation to occupant, crash and mobility data readily available to EMS at the scene, using weighted NASS-CDS data. Data set was randomly split in two for model development and evaluation.

Crash-related mortality and model year: are newer vehicles safer?

Objective: The objective of this study was to determine whether occupants of newer vehicles experience a lower risk of crash-related mortality.

Methods: The occurrence of death was studied in relation to vehicle model year (MY) among front seat vehicular occupants, age ≥ 16 captured in the National Automotive Sampling System Crashworthiness Data System (NASS-CDS) between 2000 and 2008. The associations between death and other occupant, vehicular and crash characteristics were also explored.

Disparities in trauma center access of older injured motor vehicular crash occupants.

Background: To evaluate whether older injured motor vehicular crash (MVC) occupants' access to trauma centers (TC) reflects the lower threshold suggested in triaging recommendations.

Methods: Adult front seat occupants of MVCs transported to a hospital from 1999 through 2006 included in the National Automotive Sampling System (NASS) were studied. Cases were classified by their age in years (≤60 years or >60 years).

Scene mobility status as a predictor of injury severity and mortality due to vehicular crashes.

Background: To examine the association of scene mobility status (SMS) and injury severity and mortality among motor vehicular crash (MVC) victims.

Methods: Adult MVC victims transported to medical facilities between 1997 and 2008 and included in the National Automotive Sampling System were studied. SMS was classified as follows: "ejected," "self-exited," "exited with assistance," "removed from the vehicle with decreased mental status," "removed due to perceived serious injury," and "removed for other reasons.

Are current law enforcement strategies associated with a lower risk of repeat speeding citations and crash involvement? A longitudinal study of speeding Maryland drivers.

Purpose: To determine whether traffic court appearances and different court verdicts were associated with risk of subsequent speeding citations and crashes.

Methods: A cohort of 29,754 Maryland drivers ticketed for speeding who either went to court or paid fines by mail in May/June 2003 was followed for 3 years. Drivers appearing in court were categorized by verdicts: 1) not guilty, 2) suspension of prosecution/no prosecution (STET/NP), 3) case dismissed, 4) probation before judgment (PBJ) and fines, or 5) fines and demerit points.

Occupant and crash characteristics for case occupants with cervical spine injuries sustained in motor vehicle collisions.

Background: Motor vehicle collisions (MVCs) are the leading cause of spine and spinal cord injuries in the United States. Traumatic cervical spine injuries (CSIs) result in significant morbidity and mortality. This study was designed to evaluate both the epidemiologic and biomechanical risk factors associated with CSI in MVCs by using a population-based database and to describe occupant and crashes characteristics for a subset of severe crashes in which a CSI was sustained as represented by the Crash Injury Research Engineering Network (CIREN) database.

Impulsive or depressive personality traits do not impede behavioral change after brief alcohol interventions.

The authors investigated whether impulsivity and depression affect the success of interventions to reduce alcohol use. Unadjusted and adjusted regression models were constructed to analyze the effect of impulsivity and depression on 12-month outcomes of participants of a trauma center based randomized trial of brief personalized motivational interventions versus information and advice. Of 497 problem drinkers enrolled in the program, 248 completed the 12-month follow-up.

Crash test ratings and real-world frontal crash outcomes: a CIREN study.

Objective: To establish whether the Insurance Institute for Highway Safety (IIHS) offset crash test ratings are linked to different mortality rates in real world frontal crashes.

Methods: The study used Crash Injury Research Engineering Network drivers of age older than 15 years who were involved in frontal crashes. The Crash Injury Research Engineering Network is a convenience sample of persons injured in crashes with at least one Abbreviated Injury Scale score of 3+ injury or two Abbreviated Injury Scale score of 2+ injuries who were either treated at a Level I trauma center or died.

PTSD after severe vehicular crashes.

Purpose: To describe predictors of PTSD after motor vehicle crashes (MVC).

Methods: MVC patients were interviewed during their hospitalization and at 6 and 12 months post-injury. Interviews included information about behavioral factors, circumstances around the crash, recovery and PTSD screening.

Vehicle model year and crash outcomes: a CIREN study.

Objective: To quantify the effect of model year (MY) on the occurrence of severe injuries and death after involvement in motor vehicle crashes.

Methods: Cases involving adult front seat occupants of vehicles MY > or = 1994 equipped with frontal airbags were selected from the Crash Injury Research and Engineering Network (CIREN) database. Cases were grouped by MY: 1994-1997, 1998-2004, and 2005-2007 (MY groups [MYG] 1, 2, and 3, respectively.

Crash and occupant predictors of pulmonary contusion.

Objectives: Pulmonary contusions (PCs) are a common injury sustained in motor vehicle collisions. The crash and occupant characteristics of PC in motor vehicle collisions are currently unknown. Additionally, the clinical significance and the impact on mortality have not been determined.

Expected differences and unexpected commonalities in mortality, injury severity, and injury patterns between near versus far occupants of side impact crashes.

Objective: To compare injury patterns and outcomes of near- and far-side collisions.

Methods: Near- and far-side occupants in the Crash Injury Research and Engineering Network (CIREN) were compared for mortality and the occurrence of severe injuries (maximum abbreviated injury scale [MAIS] 3+). Regression models, adjusting for confounders, examined death and MAIS 3+ injuries as outcomes and near- or far-side position as an independent variable.

Early predictors of postconcussive syndrome in a population of trauma patients with mild traumatic brain injury.

Purpose: The purpose of this analysis was to determine which of the initial symptoms after mild traumatic brain injury (MTBI) can best predict the development of persistent postconcussive syndrome (PCS).

Methods: One hundred eighty MTBI patients admitted to a level I trauma center were enrolled in a prospective study and 110 followed for 3 months. MTBI was defined as a Glasgow Coma Score of 13 to 15 with a transient loss of consciousness or report of being dazed or confused.

School suspensions, injury-prone behaviors, and injury history.

Purpose: To investigate the association of history of school suspension (HSS) to risky behaviors and injury history.

Methods: Adult patients admitted to a Level I trauma center (n = 774) were assessed for demographics, socioeconomic status, educational history, risky behaviors (infrequent seat belt use, drinking and driving, binge drinking, and speeding for a thrill), substance abuse disorders, and prior injury history. Student's t test and chi statistics were used to compare subjects with and without a HSS in relation to risky behaviors and injury history (alpha = 0.

Injury severity and outcome of overweight and obese patients after vehicular trauma: a crash injury research and engineering network (CIREN) study.

Background: This study investigates the influence of overweight and obesity on outcome from vehicular trauma.

Methods: All Crash Injury Research and Engineering Network patients older than 16 years involved in frontal and lateral crashes between 2000 and 2005 in vehicles with front airbags were included (n = 1,615). Obese, overweight, and normal-weight patients were compared in relation to injury severity score (ISS) and mortality using the Bonferroni method for multiple comparisons and the chi test.

The association between age, injury, and survival to hospital among a cohort of injured motorcyclists.

Despite the significant increase in mortality among older motorcyclists during the past decade, few studies have addressed specific injuries or mortality rates among all those injured. The purpose of this study is to describe the crash and injury characteristics among a cohort of motorcyclists injured in Maryland, and to determine the influence of age and crash type on mortality, injury patterns, and place of death (scene vs. hospital).