{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,11]],"date-time":"2026-01-11T02:28:54Z","timestamp":1768098534796,"version":"3.49.0"},"reference-count":31,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2021,4,9]],"date-time":"2021-04-09T00:00:00Z","timestamp":1617926400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["NRF-2019R1I1A1A01058960"],"award-info":[{"award-number":["NRF-2019R1I1A1A01058960"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Traumatic brain injury (TBI), also known as intracranial injury, occurs when an external force injures the brain. This study aimed to analyze the factors affecting the presence of TBI in the elderly occupants of motor vehicle crashes. We defined elderly occupants as those more than 55 years old. Damage to the vehicle was presented using the Collision Deformation Classification (CDC) code by evaluation of photos of the damaged vehicle, and a trauma score was used for evaluation of the severity of the patient\u2019s injury. A logistic regression model was used to identify factors affecting TBI in elderly occupants and a predictive model was constructed. We performed this study retrospectively and gathered all the data under the Korean In-Depth Accident Study (KIDAS) investigation system. Among 3697 patients who visited the emergency room in the regional emergency medical center due to motor vehicle crashes from 2011 to 2018, we analyzed the data of 822 elderly occupants, which were divided into two groups: the TBI patients (N = 357) and the non-TBI patients (N = 465). According to multiple logistic regression analysis, the probabilities of TBI in the elderly caused by rear-end (OR = 1.833) and multiple collisions (OR = 1.897) were higher than in frontal collision. Furthermore, the probability of TBI in the elderly was 1.677 times higher in those with unfastened seatbelts compared to those with fastened seatbelts (OR = 1.677). This study was meaningful in that it incorporated several indicators that affected the occurrence of the TBI in the elderly occupants. In addition, it was performed to determine the probability of TBI according to sex, vehicle type, seating position, seatbelt status, collision type, and crush extent using logistic regression analysis. In order to derive more precise predictive models, it would be needed to analyze more factors for vehicle damage, environment, and occupant injury in future studies.<\/jats:p>","DOI":"10.3390\/ijerph18083975","type":"journal-article","created":{"date-parts":[[2021,4,9]],"date-time":"2021-04-09T10:05:21Z","timestamp":1617962721000},"page":"3975","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["A Predictive Model to Analyze the Factors Affecting the Presence of Traumatic Brain Injury in the Elderly Occupants of Motor Vehicle Crashes Based on Korean In-Depth Accident Study (KIDAS) Database"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3254-2261","authenticated-orcid":false,"given":"Hee Young","family":"Lee","sequence":"first","affiliation":[{"name":"Automotive Medical Science Research Institute, Wonju College of Medicine, Yonsei University, Wonju 26426, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4631-1504","authenticated-orcid":false,"given":"Hyun","family":"Youk","sequence":"additional","affiliation":[{"name":"Automotive Medical Science Research Institute, Wonju College of Medicine, Yonsei University, Wonju 26426, Korea"},{"name":"Department of Emergency Medicine, Wonju College of Medicine, Yonsei University, Wonju 26426, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oh Hyun","family":"Kim","sequence":"additional","affiliation":[{"name":"Automotive Medical Science Research Institute, Wonju College of Medicine, Yonsei University, Wonju 26426, Korea"},{"name":"Department of Emergency Medicine, Wonju College of Medicine, Yonsei University, Wonju 26426, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chan Young","family":"Kang","sequence":"additional","affiliation":[{"name":"Automotive Medical Science Research Institute, Wonju College of Medicine, Yonsei University, Wonju 26426, Korea"},{"name":"Department of Emergency Medicine, Wonju College of Medicine, Yonsei University, Wonju 26426, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joon Seok","family":"Kong","sequence":"additional","affiliation":[{"name":"Automotive Medical Science Research Institute, Wonju College of Medicine, Yonsei University, Wonju 26426, Korea"},{"name":"Department of Emergency Medicine, Wonju College of Medicine, Yonsei University, Wonju 26426, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yeon Il","family":"Choo","sequence":"additional","affiliation":[{"name":"Automotive Medical Science Research Institute, Wonju College of Medicine, Yonsei University, Wonju 26426, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Doo Ruh","family":"Choi","sequence":"additional","affiliation":[{"name":"Automotive Medical Science Research Institute, Wonju College of Medicine, Yonsei University, Wonju 26426, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0548-6153","authenticated-orcid":false,"given":"Hae Ju","family":"Lee","sequence":"additional","affiliation":[{"name":"Automotive Medical Science Research Institute, Wonju College of Medicine, Yonsei University, Wonju 26426, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dong Ku","family":"Kang","sequence":"additional","affiliation":[{"name":"Automotive Medical Science Research Institute, Wonju College of Medicine, Yonsei University, Wonju 26426, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kang Hyun","family":"Lee","sequence":"additional","affiliation":[{"name":"Automotive Medical Science Research Institute, Wonju College of Medicine, Yonsei University, Wonju 26426, Korea"},{"name":"Department of Emergency Medicine, Wonju College of Medicine, Yonsei University, Wonju 26426, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,4,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1016\/0001-4575(94)00077-Y","article-title":"Characteristics of older road users and their effect on road safety","volume":"27","author":"Mori","year":"1995","journal-title":"Acid. Anal. Prev."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"151","DOI":"10.5392\/JKCA.2014.14.07.151","article-title":"The characteristics of traffic accidents and reduction methods by elderly drivers to prepare for the aging society-focused on Jeju","volume":"14","author":"Kim","year":"2014","journal-title":"J. Korea Contents Assoc."},{"key":"ref_3","unstructured":"American Geriatrics Society, and Promidor, A. (2016). Clinician\u2019s Guide to Assessing and Counselling Older Drivers, National Highway Traffic Safety Administration. [3rd ed.]."},{"key":"ref_4","unstructured":"United Nations (2015). 2015 World Population Ageing, United Nations."},{"key":"ref_5","unstructured":"United Nations (2021, February 06). Life Expectancy at Birth for Both Sexes Combined(years). Available online: http:\/\/data.un.org\/Data.aspx?q=life+expectancy&d=PopDiv&f=variableID:68&c=1,4,5,6,7,8&s=_crEngNameOrderBy:asc&p=_timeEngNameOrderBy&v=1."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1177\/0954411915592906","article-title":"Head injury predictors in sports trauma\u2013a state-of-the-art review. Proceedings of the Insti-tution of Mechanical Engineers","volume":"229","author":"Fernandes","year":"2015","journal-title":"Part H J. Eng. Med."},{"key":"ref_7","unstructured":"Peden, M., Scurfield, R., Sleet, D., Hyder, A.A., Mathers, C., Jarawan, E., and Jarawan, E. (2004). World Report on Road Traffic Injury Prevention, World Health Organization."},{"key":"ref_8","first-page":"1331","article-title":"The Impact of Discharging Minimally Injured Trauma Patient: Does Age Play a Role in Trauma Admission?","volume":"70","author":"Peschman","year":"2011","journal-title":"J. Trauma: Inj. Infect. Crit. Care"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1683","DOI":"10.1007\/s00701-015-2512-7","article-title":"Epidemiology of traumatic brain injury in Europe","volume":"157","author":"Peeters","year":"2015","journal-title":"Acta Neurochir."},{"key":"ref_10","first-page":"272","article-title":"Actual data on epidemiological evolution and prevention endeavours regarding traumatic brain injury","volume":"8","author":"Popescu","year":"2015","journal-title":"J. Med. Life"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1007\/BF03404799","article-title":"Mild Traumatic Brain Injury: The Silent Epidemic","volume":"91","author":"Feinstein","year":"2000","journal-title":"Can. J. Public Health"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1038\/nrneurol.2013.22","article-title":"Changing patterns in the epidemiology of traumatic brain injury","volume":"9","author":"Roozenbeek","year":"2013","journal-title":"Nat. Rev. Neurol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1177\/1460408616677564","article-title":"Hospitalization costs and estimates of direct and indirect economic losses due to injury sustained in road traffic crashes: Results from a one-year cohort study in three European countries (The REHABILAID project)","volume":"19","author":"Papadakaki","year":"2016","journal-title":"Trauma"},{"key":"ref_14","first-page":"S193","article-title":"Global neurotrauma research challenges and opportunities","volume":"527","author":"Rubiano","year":"2015","journal-title":"Nat. Cell Biol."},{"key":"ref_15","unstructured":"Centers for Disease Control and Prevention (2021, February 06). Traumatic Brain Injury in the United States: Fact Sheet. Updated April 27, Available online: http:\/\/www.cdc.gov\/traumaticbraininjury\/get_the_facts.html."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1016\/j.aap.2012.01.008","article-title":"Crash risk factors related to individuals sustaining and drivers following traumatic brain injuries","volume":"49","author":"Neyens","year":"2012","journal-title":"Accid. Anal. Prev."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1016\/j.injury.2016.11.011","article-title":"Psychological distress and physical disability in patients sustaining severe injuries in road traffic crashes: Results from a one-year cohort study from three European countries","volume":"48","author":"Papadakaki","year":"2017","journal-title":"Injury"},{"key":"ref_18","first-page":"1","article-title":"Guidelines for field triage of injured patients: Recommendations of the National Expert Panel on Field Triage, 2011","volume":"61","author":"Sasser","year":"2012","journal-title":"MMWR. Recomm. Rep."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"649","DOI":"10.18203\/2320-6012.ijrms20160332","article-title":"Comparison of brake reaction time in younger and older drivers","volume":"4","author":"Ashok","year":"2016","journal-title":"Int. J. Res. Med. Sci."},{"key":"ref_20","first-page":"43","article-title":"The importance and utilization plan of database based on actual accident investigation system in Korea","volume":"11","author":"Lee","year":"2019","journal-title":"J. Auto-Veh. Safety Assoc."},{"key":"ref_21","unstructured":"Society of Automotive Engineers International (2017). Collision Deformation Classification J224_201702, SAE International."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1083","DOI":"10.1016\/j.injury.2006.07.009","article-title":"AIS 2005: A contemporary injury scale","volume":"37","author":"Gennarelli","year":"2006","journal-title":"Injury"},{"key":"ref_23","unstructured":"Association for the Advancement of Automotive Medicine (2008). The Abbreviated Injury Scale 2005 Revision, Association for the Advancement of Automotive Medicine. update 2008."},{"key":"ref_24","first-page":"233","article-title":"The AIS-2005 revision in severe traumatic brain injury: Mission accomplished or problems for future research?","volume":"54","author":"Carroll","year":"2010","journal-title":"Ann. Adv. Automot. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1097\/00005373-197403000-00001","article-title":"The injury severity score: A method for describing patients with multiple injuries and evaluating emergency care","volume":"14","author":"Baker","year":"1974","journal-title":"J. Trauma Acute Care Surg."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1097\/00005373-198704000-00005","article-title":"Evaluating trauma care: The TRISS method. Trauma Score and the Injury Severity Score","volume":"27","author":"Boyd","year":"1987","journal-title":"J. Trauma"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Indrayan, A., and Holt, M.P. (2016). Concise Encyclopedia of Biostatistics for Medical Professionals, CRC Press.","DOI":"10.1201\/9781315372891"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Campbell, K.L. (1974). Energy Basis for Collision Severity, SAE International.","DOI":"10.4271\/740565"},{"key":"ref_29","unstructured":"Park, S.D. (2010). Study on Deformation of Vehicle\u2019s Frontal Crash for Traffic Accident Reconstruction. [Ph.D. Dissertation, Han-yang University]."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1197\/j.aem.2004.09.017","article-title":"Influence of the unbelted rear-seat passenger on driver mortality: \u201cthe backseat bullet\u201d","volume":"12","author":"Mayrose","year":"2005","journal-title":"Acad. Emerg. Med."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1016\/0001-4575(90)90067-U","article-title":"Restraint effectiveness, occupant ejection from cars, and fatality reductions","volume":"22","author":"Evans","year":"1990","journal-title":"Accid. Anal. 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